09 - Appareils et instruments scientifiques et électriques
10 - Appareils et instruments médicaux
Produits et services
USB chargers, adapter cables, antennas, electronics
controller for remote monitoring, electric cord. Medical devices, namely, diagnostic sensors for measuring
properties of the body, delivery catheter, delivery
guidewire, pillow for medical purpose.
2.
Apparatus and method of assessing transvascular denervation
A catheter apparatus for assessing denervation comprises: an elongated catheter body; a deployable structure coupled to the catheter body, the deployable structure being deployable outwardly from and contractible inwardly toward the longitudinal axis of the catheter body; one or more ablation elements disposed on the deployable structure to move outwardly and inwardly with the deployable structure; one or more stimulation elements spaced from each other and disposed on the deployable structure to move with the deployable structure, the stimulation elements being powered to supply nerve stimulating signals to the vessel; and one or more recording elements spaced from each other and from the stimulation elements, the recording elements being disposed on the deployable structure to move with the deployable structure, the recording elements configured to record response of the vessel to the nerve stimulating signals.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 5/24 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci
3.
Apparatus and method of assessing transvascular denervation
A catheter apparatus for assessing denervation comprises: an elongated catheter body; a deployable structure coupled to the catheter body, the deployable structure being deployable outwardly from and contractible inwardly toward the longitudinal axis of the catheter body; one or more ablation elements disposed on the deployable structure to move outwardly and inwardly with the deployable structure; one or more stimulation elements spaced from each other and disposed on the deployable structure to move with the deployable structure, the stimulation elements being powered to supply nerve stimulating signals to the vessel; and one or more recording elements spaced from each other and from the stimulation elements, the recording elements being disposed on the deployable structure to move with the deployable structure, the recording elements configured to record response of the vessel to the nerve stimulating signals.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 5/24 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci
45 - Services juridiques; services de sécurité; services personnels pour individus
Produits et services
Providing an in person and online community support network, namely, providing support services for patients, caregivers of patients and prospective patients of Ventricular Assist Device therapy via in person programs, printed and online educational materials and a cloud-based digital community
Feature of implantable pulse generators that automatically reduces the AV delay when intrinsic activity is present, sold as an integral component of implantable pulse generators
6.
Apparatus and method of assessing transvascular denervation
A catheter apparatus for assessing denervation comprises: an elongated catheter body; a deployable structure coupled to the catheter body, the deployable structure being deployable outwardly from and contractible inwardly toward the longitudinal axis of the catheter body; one or more ablation elements disposed on the deployable structure to move outwardly and inwardly with the deployable structure; one or more stimulation elements spaced from each other and disposed on the deployable structure to move with the deployable structure, the stimulation elements being powered to supply nerve stimulating signals to the vessel; and one or more recording elements spaced from each other and from the stimulation elements, the recording elements being disposed on the deployable structure to move with the deployable structure, the recording elements configured to record response of the vessel to the nerve stimulating signals.
A61B 5/04 - Mesure de signaux bioélectriques du corps ou de parties de celui-ci
A61B 18/04 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
09 - Appareils et instruments scientifiques et électriques
Produits et services
Computer hardware, software, and interfaces for use in the field of electrophysiology for collecting, mapping, visualizing, and analyzing electroanatomical data
8.
Ultrasonic lesion feedback, antipop monitoring, and force detection
An ablation catheter comprises: an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; a distal member disposed adjacent the distal end, the distal member including an ablation element to ablate a biological member; one or more acoustic transducers disposed in the distal member and each configured to direct an acoustic signal toward a respective target ablation region and receive reflection echoes therefrom; and an acoustic redirection member disposed in the distal member to at least partially redirect the acoustic signal from at least one of the acoustic transducers toward a tissue target. The distal member includes a most-distal portion, a proximal portion, and a deflectable portion between the most-distal portion and proximal portion to permit deflection between the most-distal portion and proximal portion of the distal member. The transducers and redirection member are mounted on opposite sides of the deflectable portion.
A61B 18/04 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
9.
Methods, systems, and apparatus for neural signal detection
Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal.
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Medical devices, namely, tissue and neural tissue stimulators; Medical device tools and accessories, namely, cannulas, medical tunneling tools, medical device controllers, medical device operating software, medical device leads, power adapters torque wrenches, and programmers in the nature of medical device operating firmware, all for implantation and operation of neural tissue stimulators and all sold together as a unit for medical use
11.
Apparatus and method for implanting collapsible/expandable prosthetic heart valves
Apparatus for delivering a prosthetic heart valve into a patient by means that are less invasive than conventional open-chest, open-heart surgery. The prosthetic valve may be collapsed while in a delivery device. When the valve reaches the desired implant site in the patient, the valve can be released from the delivery device, which allows the valve to re-expand to the configuration in which it can function as a heart valve. For example, the delivery device may be constructed to facilitate delivery of the prosthetic valve into the patient via the apex of the patient's heart.
Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal.
Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61B 5/04 - Mesure de signaux bioélectriques du corps ou de parties de celui-ci
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A repair device (10, 110) for repairing a heart valve leaflet in a patient includes a hollow body (11, 111) with a capture tool (20, 120) and a tissue puncture element (30, 130) at the distal end thereof. The capture tool may be used to capture and stabilize the heart valve leaflet tissue. The tissue puncture element may puncture the leaflet tissue and deploy at least one anchor (40, 240) having a length of suture (45, 245) attached thereto. By tensioning the suture, the leaflet tissue may become plicated. The tensioned suture may then be cinched to maintain the plication. The device ma hve insted of the tissue punctur element, an anchor housing tube (330) with a blunt tip, able t be put in apposition to the leaflet. In this case the anchor has a sharpened distal tip, to peetrae the tissue.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A permeable plug (10) may be temporarily deployed in a patient to protect blood vessels from blockage by various debris. The plug includes a body (15) formed from a filtering material. The body is collapsible for delivery to a location in a blood vessel and expandable to a filtering configuration in which the body occupies a cross-section of the blood vessel and is held in place by its own expansive force. At least one stud (20, 25) is connected to the body for use in deployment of the plug within the blood vessel and retrieval of the plug from the blood vessel.
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical
A61F 2/01 - Filtres implantables dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A device for transcatheter gathering of tissue of a heart valve leaflet may include an elongated tube (12) extending in a longitudinal direction and a capture tool (24) moveable in the elongated tube between a retracted position and an extended position. The elongated tube may have at least one slot (52, 252) extending generally in the longitudinal direction from a distal end of the elongated tube. The at least one slot may have an open end at the distal end of the elongated tube and a closed end remote therefrom. The capture tool may be operable to gather tissue of the heart valve leaflet into the at least one slot. The gathered tissue may have a pleated configuration.
A device for sealing a puncture in a patient includes a sealing component including an elongate control member configured to pass through a puncture in skin of a patient. The sealing component also includes an expandable member disposed near a distal end of the control member, and a tip releasably attached to the elongate control member distal to the expandable member. The device also includes a sealing material delivery component including a delivery tube through which the control member of the sealing component is configured to extend. The delivery tube is configured to deliver sealing material through an opening in a distal end of the delivery tube.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
18.
Apparatus and method for implanting collapsible/expandable prosthetic heart valves
Apparatus for delivering a prosthetic heart valve into a patient by means that are less invasive than conventional open-chest, open-heart surgery. The prosthetic valve may be collapsed while in a delivery device. When the valve reaches the desired implant site in the patient, the valve can be released from the delivery device, which allows the valve to re-expand to the configuration in which it can function as a heart valve. For example, the delivery device may be constructed to facilitate delivery of the prosthetic valve into the patient via the apex of the patient's heart.
An ablation catheter comprises: an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; a distal member disposed adjacent the distal end, the distal member including an ablation element to ablate a biological member; one or more acoustic transducers disposed in the distal member and each configured to direct an acoustic signal toward a respective target ablation region and receive reflection echoes therefrom; and an acoustic redirection member disposed in the distal member to at least partially redirect the acoustic signal from at least one of the acoustic transducers toward a tissue target. The distal member includes a most-distal portion, a proximal portion, and a deflectable portion between the most-distal portion and proximal portion to permit deflection between the most-distal portion and proximal portion of the distal member. The transducers and redirection member are mounted on opposite sides of the deflectable portion.
A61B 18/04 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage
20.
CLIP DELIVERY SYSTEM FOR HEART VALVE REPAIR AND METHOD OF USE
A device for repair of a heart valve leaflet includes an elongated body having a lumen extending therethrough in a longitudinal direction, a proximal end, and an open distal end. The device further includes a plurality of clips disposed at spaced positions within the lumen, the plurality of clips being configured and arranged to couple to a portion of the heart valve leaflet. At least one clip in the plurality of clips and the heart valve leaflet are capable of translation relative to one another in the longitudinal direction.
A device 10 for gathering tissue of a heart valve leaflet 2 may include an outer tube 16 extending in an elongation direction, a capture tool 22 moveable in the outer tube between a contained position and a use position, and a tissue securing component 32 disposed at a distal end 17 of the outer tube and adapted to be applied to tissue 8 captured by the capture tool to hold the captured tissue in a gathered configuration. The capture tool may include a first element 20 and a second element 22 that are moveable relative to one another in the elongation direction. The first and second elements 20, 22 may be operable to capture tissue 8 of the heart valve leaflet 2 therebetween and to draw the captured tissue into the outer tube 16 in the gathered configuration.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A device 10 for gathering tissue in a patient includes an elongated catheter 14 and a capture assembly 13 at a distal portion of the catheter. The capture assembly has a closed side 18 and a door 20 rotatable between an open condition and a closed condition. The closed side 18 of the capture assembly 13 and the door 20 in the closed condition may collectively define a tissue capturing compartment 19. Movement of the door 20 from the open condition to the closed condition adjacent the tissue may capture a portion 44 of the tissue in the tissue capturing compartment 19. A clip may then be applied from the capture assembly 13 to the captured tissue 44 to hold the tissue substantially in a gathered configuration.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
Embodiments of the present invention provide minimally invasive catheter devices and methods for denervation that involve physically severing one or more nerves using a tool provided in a distal portion of the catheter that is introduced into a vessel of a patient such as a renal artery or vein. In some preferred embodiments, the denervation does not substantially raise the temperature of the region of the vessel being denervated. In specific embodiments, the one or more nerves being physically severed are cauterized to stop any potential or actual bleeding or leakage, preferably using a tool provided in the distal portion of the catheter.
A61B 18/04 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage
A device and method for repairing a mitral valve leaflet 2, 3. The device 10 includes a body 16 having an annular wall 18 and at least one aperture 22 through the annular wall 18. A deployment assembly 24 mounted on the body includes at least one grasping wire 28 arranged for sliding movement in the aperture 22. Movement of the deployment assembly 24 to a deployed position relative to the body causes a free end of the grasping wire 28 to project out from the annular wall 18 through the aperture 22, and movement of the deployment assembly to a retracted position relative to the body causes the free end of the grasping wire 28 to not project out from the annular wall 18. In the deployed position, the grasping wire 28 may grasp and gather tissue of the leaflet 2,3.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour réaliser l'anastomoseBoutons pour anastomose
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A clip (100, 200, 900, 1000, 1100, 1200) for repairing a cardiac valve includes an elongated body (102, 202, 902, 1132, 1202, 1302) and a locking mechanism (110, 1110, 1210, 1310). The elongated body has first and second ends and is adapted to change between an open condition and a closed condition. The locking mechanism is adapted to lock the elongated body in the closed condition. The locking mechanism may include interengaging teeth (116, 118; 212, 214) on the first end (1104, 1204, 1304) and second end (1106, 1206, 1306) of the body. Alternatively, the locking mechanism may include a return (1121, 1212, 1312) on the first end of the body sized to overlap with the second end of the body in the closed condition.
A mandrel (5) for molding polymer valve leaflets for heart valve prostheses is disclosed, including a body portion (52) including an outer surface with ridges (60) and contoured surfaces (64) corresponding to the leaflets, the upper edge of the contoured surfaces corresponding to the free upper edge of the leaflets, and the mandrel includinga mandrel extension (54) above the body portion, and a gap (68) extending around the mandrel between the upper edge of the contoured surface and the mandrel extension. A process for producing these polymer valve leaflets is also disclosed by dip coating with this mandrel and removing the polymer film created at the gap, preferably by applying suction or blowing thereto.
A delivery device (13) for a collapsible prosthetic heart valve (1) includes a support shaft (21) around which a compartment (23) for the valve is defined, a distal sheath (24) adapted to selectively cover and uncover the compartment and the valve, and a marker cage (30) having a collapsed condition when the distal sheath covers the compartment and an expanded condition when the compartment is uncovered. The marker cage includes at least one rib (33) having a radiopaque marker (34) for determining the positioning of the valve as it is deployed. The valve may be assembled around the marker cage so that the marker cage does not interfere with the radial expansion of the valve during deployment.
An optical coherence tomography rotation catheter comprises a catheter body and a tubular member that rotates around a longitudinal axis in the catheter body. An optical fiber extends along an interior of the tubular member and has an optical fiber distal end. A light reflecting member is distal of the optical fiber distal end and rotates around the longitudinal axis with the tubular member. The light reflecting member includes a light reflecting surface which is spaced from and faces the optical fiber distal end and which is inclined to reflect the light from the optical fiber in a radial direction at an angle with respect to the longitudinal axis. The light reflecting member has a diameter of at most about 0.25 mm. The light reflecting surface is polished and coated with a light reflecting film.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p. ex. endoscopesDispositions pour l'éclairage dans ces instruments
29.
HIGH SPATIAL RESOLUTION OPTICAL COHERENCE TOMOGRAPHY ROTATION CATHETER
An optical coherence tomography rotation catheter comprises a catheter body (40) and a tubular member (10) that rotates around a longitudinal axis in the catheter body. An optical fiber (20) extends along an interior of the tubular member and has an optical fiber distal end. A light reflecting member (22) is distal of the optical fiber distal end and rotates around the longitudinal axis with the tubular member. The light reflecting member includes a light reflecting surface which is spaced from and faces the optical fiber distal end and which is inclined to reflect the light from the optical fiber in a radial direction at an angle with respect to the longitudinal axis. The light reflecting member has a diameter of at most about 0.25 mm. The light reflecting surface is polished and coated with a light reflecting film.
A61B 6/00 - Appareils ou dispositifs pour le diagnostic par radiationsAppareils ou dispositifs pour le diagnostic par radiations combinés avec un équipement de thérapie par radiations
A device 10 for repairing mitral valve leaflets 2, 3 includes a jaw mechanism 15 that may be positioned adjacent a mitral valve leaflet 2, 3. The jaw mechanism 15 may move between an open position and a closed position by pivoting a first jaw relative 16 to a second jaw 18. The first jaw 16 may include a rivet 28 that may move from a stored position to an application position projecting away from the first jaw 16 when the jaw mechanism 15 is moved from the closed to the open position. Closing the jaws 16, 18 about a valve leaflet 2, 3 causes the rivet 28 to pierce the leaflet. The jaw mechanism 15 may then be rotated to wind the leaflet 2, 3 thereabout and again pierce the leaflet. The rivet 28 may then be released from the jaw mechanism 25 and the device 10 removed from the patient.
A collapsible prosthetic heart valve includes a stent (100, 300, 600) and a valve assembly (200, 400, 700). The stent includes an annulus section (108, 308, 608) and at least one foldable section (110, 310, 610). The stent is movable between an unfolded condition in which the foldable section is longitudinally spaced from the annulus section, and a folded condition in which the foldable section is at least partially positioned radially adjacent the annulus section. The valve assembly is positioned within the annulus section of the stent in the folded condition of the stent.
A method for denervation comprises introducing a distal portion of a catheter through an interior of a vessel of a patient to a location at or proximate one of a renal pelvis or a calyx. The catheter includes an elongated catheter body extending longitudinally between a proximal end and a distal end. The catheter body includes the distal portion at the distal end and a catheter lumen from the proximal end to the distal end. Energy is delivered from the distal portion to cause renal denervation, for example, by denervating at least some tissue proximate at least one of the renal pelvis or a renal vessel from a location at or proximate the renal pelvis or the calyx from a location at or proximate the calyx.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes
33.
Combination catheter for forward and side lesioning with acoustic lesion feedback capability
An ablation system comprises a catheter including a pulse-echo ultrasonic transducer disposed in a distal portion and arranged to emit and receive an acoustic beam. The transducer emits and receives acoustic pulses to provide transducer detected information regarding the targeted tissue region being ablated. A rotation mechanism rotates at least the distal portion around a longitudinal axis of the catheter. A control and interface system processes the transducer detected information and provides feedback to a user via a user interface and/or the control and interface system to be used to control ablation. The transducer detected information includes a detected lesion depth along a beam emanation direction. The control and interface system includes a lesion depth correction module which converts the detected lesion depth along the beam direction to a corrected lesion depth in a normal direction which is perpendicular to the tissue surface in contact with the ablation element.
An ablation system comprises a catheter (1) including a pulse-echo ultrasonic transducer (5a, 5b) disposed in a distal portion and arranged to emit and receive an acoustic beam. The transducer emits and receives acoustic pulses to provide transducer detected information regarding the targeted tissue region being ablated. A rotation mechanism rotates at least the distal portion around a longitudinal axis of the catheter. A control and interface system (10) processes the transducer detected information and provides feedback to a user via a user interface and/or the control and interface system to be used to control ablation. The transducer detected information includes a detected lesion depth along a beam emanation direction. The control and interface system includes a lesion depth correction module (10a) which converts the detected lesion depth along the beam direction to a corrected lesion depth in a normal direction which is perpendicular to the tissue surface in contact with the ablation element.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
A catheter apparatus for assessing denervation comprises: an elongated catheter body; a deployable structure (30) coupled to the catheter body, the deployable structure being deployable outwardly from and contractible inwardly toward the longitudinal axis of the catheter body; one or more ablation elements (11-14) disposed on the deployable structure to move outwardly and inwardly with the deployable structure; one or more stimulation elements (e.g., 13, 15) spaced from each other and disposed on the deployable structure to move with the deployable structure, the stimulation elements being powered to supply nerve stimulating signals to the vessel; and one or more recording elements (e.g., 11, 12, 14, 16) spaced from each other and from the stimulation elements, the recording elements being disposed on the deployable structure to move with the deployable structure, the recording elements configured to record response of the vessel to the nerve stimulating signals.
A lead (2) for nerve modulation comprises an elongated body which includes a proximal end, a distal portion having a distal end, and an intermediate portion disposed between the proximal end and the distal portion. The distal portion includes a distal portion anchoring mechanism (82, 92, 102) to anchor the distal portion to a first biological cavity of a patient. The intermediate portion includes an intermediate portion anchoring mechanism (84, 94, 104) to anchor the intermediate portion to a second biological cavity of the patient. The intermediate portion anchoring mechanism is larger in lateral dimension than and is spaced from the distal portion anchoring mechanism. The distal portion and/or the intermediate portion include a plurality of modulation electrodes (86, 96, 106). The distal portion anchoring mechanism and/or the intermediate portion anchoring mechanism is configured to position the modulation electrodes to contact tissue of the patient at multiple locations.
A transvenous renal nerve modulation system comprises: a blood pressure monitoring device (106) to be implanted in a patient to monitor the patient's blood pressure; one or more transvenous renal nerve modulation leads (110) to be implanted in one or more renal blood vessels of the patient; a pulse generator (102) coupled to the transvenous renal nerve modulation leads to deliver electrical pulses to the one or more transvenous renal nerve modulation leads for modulating renal nerves of the patient; and a control unit (104) coupled to the blood pressure monitoring device and the pulse generator to control delivery of the electrical pulses by the pulse generator based on the patient's blood pressure from the blood pressure monitoring device. The pulse generator delivers high frequency pulses of greater than about 10 Hz to the transvenous renal nerve modulation leads if the patient's blood pressure is greater than a high blood pressure threshold.
A method for performing elastographic deformation mapping of tissues and plaques comprises: introducing a distal portion of a catheter to an interior of an interior body of a patient; applying, from a palpator in the distal portion, one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.
A61B 5/05 - Détection, mesure ou enregistrement pour établir un diagnostic au moyen de courants électriques ou de champs magnétiquesMesure utilisant des micro-ondes ou des ondes radio
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 5/02 - Détection, mesure ou enregistrement en vue de l'évaluation du système cardio-vasculaire, p. ex. mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin
An optical coherence tomography (OCT) catheter, for performing high performance elastographic deformation mapping of tissues and plaques, comprises: a catheter (20) having an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including a distal portion (24) at the distal end and a catheter lumen (26); a palpator (30), disposed in the distal portion, to apply one of a directed fluid or a mechanical indenter (130) to produce a surface - applied palpation force to a target area (50) of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and an OCT imaging sensor (34), disposed in the distal portion, to direct and deliver an OCT beam (60) for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 5/02 - Détection, mesure ou enregistrement en vue de l'évaluation du système cardio-vasculaire, p. ex. mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin
A system for ablation with acoustic feedback comprises: a catheter which includes an elongated catheter body; at least one ablation element to ablate a targeted tissue region; and a pulse-echo ultrasonic transducer arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer beam angle of between about 30 degrees and about 60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam of the ultrasonic transducer, wherein the transducer transmits and receives acoustic pulses to provide lesion information in the targeted tissue region; an ablation power subsystem; an ultrasonic transmit and receive subsystem to operate the ultrasonic transducer; a control subsystem to control operation of the ablation power subsystem and the ultrasonic transmit and receive subsystem; and a display.
A61B 8/00 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores
41.
ACOUSTIC TRANSDUCER FOR PULSE-ECHO MONITORING AND CONTROL OF THERMALLY ABLATIVE LESIONING IN LAYERED AND NONLAYERED TISSUES, CATHETER CONTACT MONITORING, TISSUE THICKNESS MEASUREMENT AND PRE-POP WARNING
An ablation catheter with acoustic monitoring comprises an elongated catheter body; a distal member disposed adjacent a distal end and including an ablation element to ablate a biological member at a target region outside the catheter body; and one or more acoustic transducers (5) each configured to direct an acoustic beam (6) toward a respective target ablation region and receive reflection echoes therefrom. The distal member includes a transducer housing in which the acoustic transducers (5a, 5b) are disposed, the transducer housing including at least one transducer window which is the only portion in the distal member through which the acoustic beam passes, at least the at least one transducer window portion of the distal member being made of a material (5c) comprising at least 50% carbon by volume, the transducer window material (5c) having an acoustic impedance between that of the acoustic transducers and that of the biological member.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
42.
SINGLE TRANSDUCER WITH ANGULAR ORIENTATION FOR LESION FEEDBACK IN ABLATION CATHETER
An ablation catheter comprises: an elongated catheter body (1b) extending along a longitudinal axis; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body to ablate a targeted tissue region outside the catheter body; a single pulse-echo ultrasonic transducer (1c, 1d) disposed in the distal portion and arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer angle (θXc) of about 30-60 degrees relative to a distal direction of the longitudinal axis (Xc) at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam; and a mechanism to manipulate the distal portion in movement including rotation of at least the distal portion around the longitudinal axis. The single ultrasonic transducer emits and receives acoustic pulses to provide lesion information in the targeted tissue region being ablated.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
A system for ablation with acoustic feedback comprises: a catheter (102) which includes an elongated catheter body; at least one ablation element to ablate a targeted tissue region; and a pulse-echo ultrasonic transducer (111) arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer beam angle (ϒ) of between about 30 degrees and about 60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam of the ultrasonic transducer, wherein the transducer transmits and receives acoustic pulses to provide lesion information in the targeted tissue region; an ablation power subsystem (105); an ultrasonic transmit and receive subsystem (106) to operate the ultrasonic transducer; a control subsystem (104) to control operation of the ablation power subsystem and the ultrasonic transmit and receive subsystem; and a display (107).
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
A signal interrogation system comprises an optical coupler (22) to split input laser beam into a first laser beam as a power reference and a second laser beam, the optical coupler being coupled to a first path (24) for the first laser beam and a second path (25) for the second laser beam; an optical circulator (28) disposed in the second path; a bi-directional optical switch (30) disposed in the second path and having on one side a single channel end oriented toward the optical circulator and on another side multiple channel ends with multiple switchable channels; a plurality of optical fibers (34) coupled to the multiple channel ends of the bi-directional optical switch; an interference optical signals path (44) coupled to the optical circulator to receive the interference optical signals from the bi-directional switch; and a balanced photo detector (50) to measure a power difference between the interference optical signals and the power reference.
A signal interrogation system comprises an optical coupler to split input laser beam into a first laser beam as a power reference and a second laser beam, the optical coupler being coupled to a first path for the first laser beam and a second path for the second laser beam; an optical circulator disposed in the second path; a bi-directional optical switch disposed in the second path and having on one side a single channel end oriented toward the optical circulator and on another side multiple channel ends with multiple switchable channels; a plurality of optical fibers coupled to the multiple channel ends of the bi-directional optical switch; an interference optical signals path coupled to the optical circulator to receive the interference optical signals from the bi-directional switch; and a balanced photo detector to measure a power difference between the interference optical signals and the power reference.
Embodiments of the invention provide multi-channel OCT (Optical Coherence Tomography) for imaging biological tissue, and for temperature and/or force sensing, preferably in real time. In one embodiment, an optical signal processing system comprises: a processor; a memory; a receiving module to receive in real time input from multiple channels of OCT producing interfering optical signals representing multiple measured distances for a target imaging object; a Fast Fourier Transform (FFT) module to apply FFT on the interfering optical signals in real time to produce Fourier frequencies corresponding to the multiple measured distances; and a calculation module to calculate in real time multiple force components of a force applied on the target imaging object to cause at least some of the multiple measured distances for the target imaging object based on the Fourier frequencies from the FFT module.
G01L 1/00 - Mesure des forces ou des contraintes, en général
G01L 3/00 - Mesure du couple, du travail, de la puissance ou du rendement mécanique en général
G01L 5/00 - Appareils ou procédés pour la mesure des forces, du travail, de la puissance mécanique ou du couple, spécialement adaptés à des fins spécifiques
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
G01L 3/10 - Dynamomètres de transmission rotatifs dans lesquels l'élément transmettant le couple comporte un arbre élastique en torsion impliquant des moyens électriques ou magnétiques d'indication
48.
MULTI-CHANNEL OPTICAL COHERENCE TOMOGRAPHY FOR IMAGING AND TEMPERATURE AND FORCE SENSING
Embodiments of the invention provide multi-channel OCT (Optical Coherence Tomography) for imaging biological tissue or the like, and for temperature and/or force sensing, preferably in real time. In one embodiment, an optical signal processing system (200) comprises: a processor (202); a memory (204); a receiving module (210) to receive in real time input from multiple channels of OCT producing interfering optical signals representing multiple measured distances for a target imaging object; a Fast Fourier Transform (FFT) module (212) to apply FFT on the interfering optical signals in real time to produce Fourier frequencies corresponding to the multiple measured distances; and a calculation module (214) to calculate in real time multiple force components of a force applied on the target imaging object to cause at least some of the multiple measured distances for the target imaging object based on the Fourier frequencies from the FFT module.
An adjustment assembly for an adjustable prosthetic valve device includes a gearbox housing formed from two gearbox shells coupled to one another and held together by two gearbox sleeves each having an internal cavity adapted to accommodate respective lateral portions of the gearbox shells when the gearbox shells are coupled to one another. A gear assembly, including a center gear and two driven gears, is supported within the gearbox housing. Gear teeth of each of the driven gears engage gear teeth of the center gear such that rotation of the center gear causes rotation of the driven gears. At least one of the driven gears is adapted to engage a transmission mechanism that transmits the rotation thereof to another part of the adjustable prosthetic valve device to accomplish an adjustment to the size and/or shape of the adjustable prosthetic valve device.
An adjustment tool enables manipulation of a prosthetic anatomical device such as an annuloplasty ring. The tool includes a compression member which is operative for retarding rotation of the adjustment shaft to preclude inadvertent rotation thereof during use of the tool by the surgeon. A locking device is associated with the adjustment tool to enable the releasable attachment of the tool to the anatomical device during its adjustment by manipulation of the tool. The locking device is oriented into operative and inoperative positions by the engagement and disengagement of locking elements. A scale may be provided on the adjustment tool to assist a surgeon in determining the size or amount of adjustment to the size of the anatomical device during its adjustment.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
B25B 23/142 - Agencement pour limiter le couple de blocage ou pour indiquer le couple des clés ou des tournevis spécialement adapté aux clés ou tournevis à main
B25B 15/02 - Tournevis actionnés en tournant la poignée
B25G 1/04 - Fabrication des manches télescopiquesFabrication des manches extensiblesFabrication des manches en plusieurs sections
An adjustment tool enables manipulation of a prosthetic anatomical device such as an annuloplasty ring. The tool includes a compression member which is operative for retarding rotation of the adjustment shaft to preclude inadvertent rotation thereof during use of the tool by the surgeon. A locking device is associated with the adjustment tool to enable the releasable attachment of the tool to the anatomical device during its adjustment by manipulation of the tool. The locking device is oriented into operative and inoperative positions by the engagement and disengagement of locking elements. A scale may be provided on the adjustment tool to assist a surgeon in determining the size or amount of adjustment to the size of the anatomical device during its adjustment.
B25B 23/142 - Agencement pour limiter le couple de blocage ou pour indiquer le couple des clés ou des tournevis spécialement adapté aux clés ou tournevis à main
B25B 15/02 - Tournevis actionnés en tournant la poignée
B25G 1/04 - Fabrication des manches télescopiquesFabrication des manches extensiblesFabrication des manches en plusieurs sections
An adjustment tool enables manipulation of a prosthetic anatomical device such as an annuloplasty ring. The tool includes a compression member which is operative for retarding rotation of the adjustment shaft to preclude inadvertent rotation thereof during use of the tool by the surgeon. A locking device is associated with the adjustment tool to enable the releasable attachment of the tool to the anatomical device during its adjustment by manipulation of the tool. The locking device is oriented into operative and inoperative positions by the engagement and disengagement of locking elements. A scale may be provided on the adjustment tool to assist a surgeon in determining the size or amount of adjustment to the size of the anatomical device during its adjustment.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
B25B 23/142 - Agencement pour limiter le couple de blocage ou pour indiquer le couple des clés ou des tournevis spécialement adapté aux clés ou tournevis à main
B25B 15/02 - Tournevis actionnés en tournant la poignée
B25G 1/04 - Fabrication des manches télescopiquesFabrication des manches extensiblesFabrication des manches en plusieurs sections
53.
ADJUSTABLE PROSTHETIC ANATOMICAL DEVICE HOLDER AND HANDLE FOR THE IMPLANTATION OF AN ANNULOPLASTY RING
An adjustable prosthetic anatomical holder system is disclosed. The system is adaptable for use in cardiac surgery and may include an adjustable annuloplasty ring, a ring holder, and a positioning handle. The adjustable annuloplasty ring holder facilitates placement and adjustment of the annuloplasty ring during a cardiac surgical procedure. An optional positioning handle holds the adjustable annuloplasty ring during placement and suturing of the ring. The ring holder is constructed from two members that are slidably fit together in telescopic arrangement to accommodate adjustment of the ring size.
A transcatheter method of gathering tissue of a heart valve leaflet may include inserting an elongated catheter assembly (12) to a position adjacent the heart valve leaflet, the catheter assembly including a capture tool (22) moveable between a retracted position and an extended position, a tissue support (40), and a clamping member (30) moveable between an open position and a closed position. The capture tool may be partially retracted to gather tissue of the heart valve leaflet between the tissue support and the clamping member. The clamping member may then be moved from the open position toward the closed position so as to clamp a substantial portion of the gathered tissue of the heart valve leaflet between the tissue support and the clamping member. Subsequently, a clip (55) may be applied from the catheter assembly to the clamped tissue so as to hold the clamped tissue substantially in a gathered configuration.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
55.
SYSTEM AND METHOD FOR LOADING A COLLAPSIBLE HEART VALVE INTO A DELIVERY DEVICE
An assembly (200) for collapsing a self - expanding prosthetic heart valve includes a compression member (202) a support member (204) and a constricting member (300). The compression member has a tapered wall between its first open end and its second open end, the tapered wall defining an open space adapted to receive the valve. The support member has a base (220) and a recess (226) adapted to receive an end of the valve. The support member and the compression member are movable toward one another to compress the valve and push it through a relatively small aperture in the second open end of the compression member. The second end of the constricting member is sized to receive the compressed valve from the second open end of the compression member for loading into a delivery device.
A61F 2/00 - Filtres implantables dans les vaisseaux sanguinsProthèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corpsAppareils pour les assujettir au corpsDispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p. ex. stents
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/97 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure la gaine extérieure pouvant être fendue
56.
ULTRASOUND ABLATION APPARATUS WITH DISCRETE STAGGERED ABLATION ZONES
An ablation apparatus comprises an ultrasonic transducer (300) which includes piezoelectric element (302) having cylindrical shape; external electrodes (306a, 306b) disposed on the outer surface of the piezoelectric element; and at least one internal electrode (308) disposed on the inner surface of the piezoelectric element. The at least one internal electrode provides corresponding internal electrode portions that are disposed opposite the external electrodes with respect to the piezoelectric element, the external electrodes and the internal electrode to be energized to apply an electric field across the piezoelectric element. The ultrasonic ablation zones (316a, 316b) of the external electrodes are distributed in a staggered configuration so as to span one or more open arc segments around the longitudinal axis (310), and the ultrasound ablation zones of all external electrodes projected longitudinally onto any lateral plane which is perpendicular to the longitudinal axis span a substantially closed loop around the longitudinal axis.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A delivery device (10) for a collapsible heart valve includes an operating handle (20), including a frame (30) defining a movement space therein, a carriage assembly (40) moveable within the movement space, and a first resheathing lock (44) having a locked position and an unlocked position. The delivery device further includes a catheter assembly, including a first shaft (26) around which a valve receiving compartment (23) is defined, the first shaft being fixedly connected to one of the frame or the carriage assembly, and a distal sheath (24) operatively connected to the carriage assembly. The distal sheath is moveable between a closed condition adapted to maintain the valve in the compartment and an open condition adapted to fully deploy the valve. With the resheathing lock in the locked position, the distal sheath is unable to move to the open condition to fully deploy the valve.
A delivery system (110) for delivering a collapsible prosthetic heart valve includes a valve support structure (132) for supporting a collapsible prosthetic heart valve, and a distal sheath (130) movable in a longitudinal direction relative to the valve support structure between a first position in which the distal sheath is adapted to surround a collapsible prosthetic heart valve supported on the valve support structure, and a second position in which the distal sheath is adapted to expose the collapsible prosthetic heart valve for deployment. The distal sheath is at least partially formed of an inner polymer layer, an outer polymer layer, and a tubular supporting member sandwiched between the inner polymer layer and the outer polymer layer.
A delivery system for delivering and deploying a medical implant, such as a prosthetic heart valve, includes an elongated support member (28), a sheath (30), and a tip (132). The sheath is movable relative to the elongated support member between a distal position overlying the medical implant and a proximal position exposing the medical implant for release from the delivery system. The tip is attached to the elongated support member and is positioned at a distal end of the sheath when the sheath is in the distal position. The tip has a compressed condition and an expanded condition, and a maximum diameter in the expanded condition that is larger than the outer diameter of the sheath.
A delivery device (10) for an implantable medical device includes an inner shaft (26) extending in a longitudinal direction and defining a compartment (23) adapted to receive the medical device in an assembled condition, an outer shaft (22) surrounding a longitudinal portion of the inner shaft, and a distal sheath (24) operatively attached to the outer shaft (22). The distal sheath (24) is slidable between a first position enclosing the compartment (23) and a second position exposing the compartment (23) for deployment of the medical device. A sleeve 30 surrounds at least a longitudinal portion of the outer shaft (22) and provides a substantially blood tight bearing surface that facilitates sliding movement of the delivery device (10) in an introducer (2).
A delivery device (10) for an implantable medical device having at least one retention member at an end thereof includes a shaft (24) extending in a longitudinal direction, an elongated sheath (22) surrounding a longitudinal portion of the shaft, a compartment (28) defined inside of the sheath and adapted to receive the medical device in an assembled condition, a retainer (30) positioned at one end of the compartment, and at least one acceptance (36) in the retainer adapted to receive the retention member of the medical device in the assembled condition. The sheath is slidable relative to the shaft in the longitudinal direction to uncover and deploy the medical device. The retainer may be rotatable relative to the shaft to reduce torsional forces in the medical device during delivery and deployment. The retainer may have at least one recess facing the compartment for receiving a strut at an end of a stent of the medical device.
Embodiments of the invention provide a fiberoptic device that uses a gradient-index (GRIN) lens for focusing a light beam emitted by an optical fiber, but achieves a substantially longer focal length than that of a GRIN lens alone by placing a beam expander (e.g., no core fiber or step-index multimode fiber) between the terminal end of the optical fiber and the GRIN lens to simulate free space therebetween. In one embodiment, a fiberoptic device comprises an optical fiber having a fiber core and an end through which a light beam emits from the fiber core; a beam expander having a first end coupled to the end of the optical fiber and having a second end, the beam expander permitting the light beam emitting from the fiber core to pass from the first end to the second end and to expand from the first end to a larger size at the second end; and a gradient-index fiber lens coupled to the second end of the beam expander to receive the light beam from the beam expander and focus the light beam.
A fiberoptic device achieves a substantially longer focal length by placing a beam expander between the terminal end of an optical fiber and a gradient-index (GRIN) lens to simulate free space therebetween. In one embodiment, a fiberoptic device comprises an optical fiber having a fiber core and an end through which a light beam emits from the fiber core; a beam expander having a first end coupled to the end of the optical fiber and having a second end, the beam expander permitting the light beam emitting from the fiber core to pass from the first end to the second end and to expand from the first end to a larger size at the second end; and a gradient-index fiber lens coupled to the second end of the beam expander to receive the light beam from the beam expander and focus the light beam.
A catheter apparatus comprises an elongated catheter body having a distal end, a proximal end, and at least one fluid lumen extending longitudinally therein; and a plurality of flexible electrode segments on a distal portion of the catheter body adjacent the distal end, each pair of neighboring flexible electrode segments being spaced from each other longitudinally by a corresponding electrically nonconductive segment. Each flexible electrode segment comprises a sidewall provided with one or more elongated stiffness reductions extending through the sidewall, the one or more elongated stiffness reductions providing flexibility in the sidewall for bending movement relative to a longitudinal axis of the catheter body. The electrically nonconductive segment is substantially smaller in length than each of the corresponding pair of neighboring flexible electrode segments.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
65.
CATHETER HAVING FLEXIBLE TIP WITH MULTIPLE FLEXIBLE SEGMENTS
A catheter apparatus includes an elongated body having a distal portion including a distal end, a plurality of flexible segments, and at least one intermediate segment that is less flexible than the flexible segments. Adjacent flexible segments are spaced from each other longitudinally by the at least one intermediate segment. Each of the flexible segments include a sidewall having at least one elongated gap extending at least partially therethrough and forming interlocking members. The at least one intermediate segment is shorter than the flexible segments.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes
A prosthetic heart valve (300) includes a stent (301) and a valve assembly attached to the stent. The stent has a longitudinal axis, a distal end (302) and a proximal end (304) adapted to reside adjacent the aortic annulus of a patient. The proximal end of the stent is oriented at an oblique angle to the longitudinal axis.
A lead includes an elongated body and an anchor segment disposed between the distal end of the body and electrodes on a distal portion of the body. The anchor segment has lobes which are separated by slits and movable between a collapsed position and an expanded position. A positioning mechanism is disposed inside the hollow interior of the body and at least partially within the anchor segment. The positioning mechanism has a distal positioning portion attached to the distal end of the body and a proximal positioning portion. A control member is connected with the proximal positioning portion to control the positioning mechanism to pull the distal end toward the proximal end so as to move the lobes from the collapsed position to the expanded position and to push the distal end away from the proximal end so as to move the lobes from the expanded to the collapsed position.
A closure device includes a delivery member, a sealing material applicator, and an expandable member. The delivery member is insertable through a tissue tract to a vessel puncture. The sealing material applicator is configured to supply a volume of sealing material to the delivery member and includes first and second multi-chamber devices and a valve assembly. Each chamber of the first and second multi-chamber devices holds a component of the sealing material, and operating the valve assembly permits mixing of at least some of the components prior to connecting the sealing material applicator to the delivery member. The expandable member is positionable within the vessel to temporarily seal closed the vessel puncture from within the vessel. The closure device is operable to deliver the sealing material from the sealing material applicator, through the delivery member, and to the tissue tract to seal closed the vessel puncture from outside the vessel.
A puncture closure device operable to seal closed a vessel puncture in a vessel. The puncture closure device includes a delivery member insertable through a tissue tract to the vessel puncture, a sealing material, and an expandable member. The sealing material is deliverable through the delivery member to the vessel puncture and configured to seal closed the vessel puncture from outside the vessel. The expandable member is positionable within the vessel through a vessel access distinct from the vessel puncture and is operable to temporarily seal closed the vessel puncture from within the vessel to restrict passage of the sealing material into the vessel.
A puncture closure device operable to seal closed a vessel puncture in a vessel. The puncture closure device includes a delivery member insertable through a tissue tract to the vessel puncture, a sealing material, and an expandable member. The sealing material is deliverable through the delivery member to the vessel puncture and configured to seal closed the vessel puncture from outside the vessel. The expandable member is positionable within the vessel through a vessel access distinct from the vessel puncture and is operable to temporarily seal closed the vessel puncture from within the vessel to restrict passage of the sealing material into the vessel.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
An ablation catheter comprises a catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; and an ablation element assembly comprising ablation elements connected to the catheter body, each ablation element to be energized to produce an ablation zone. The ablation elements are distributed in a staggered configuration such that the ablation zones of the ablation elements span one or more open arc segments around the longitudinal axis, but the ablation zones of all ablation elements projected longitudinally onto any lateral plane which is perpendicular to the longitudinal axis span a substantially closed loop around the longitudinal axis. Since the ablation zones do not form a closed loop, the risk of renal artery/vein stenosis is reduced or eliminated. Since the ablation zones of all ablation elements projected longitudinally onto any lateral plane span a substantially closed loop, substantially complete renal denervation is achieved.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
An ablation catheter comprises a catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; and an ablation element assembly comprising ablation elements connected to the catheter body, each ablation element to be energized to produce an ablation zone. The ablation elements are distributed in a staggered configuration such that the ablation zones of the ablation elements span one or more open arc segments around the longitudinal axis, but the ablation zones of all ablation elements projected longitudinally onto any lateral plane which is perpendicular to the longitudinal axis span a substantially closed loop around the longitudinal axis. Since the ablation zones do not form a closed loop, the risk of renal artery/vein stenosis is reduced or eliminated. Since the ablation zones of all ablation elements projected longitudinally onto any lateral plane span a substantially closed loop, substantially complete renal denervation is achieved.
A system for delivering a collapsible and re-expandable prosthetic heart valve into a patient includes a valve support structure (140) around which the valve (10) is disposed in a collapsed condition. A sheath structure (110) surrounds the collapsed valve, but can be moved relative to the valve to uncover it for expansion at the desired implant site in the patient. The sheath structure may be variously mounted and moved to deploy the valve in various ways. For example, the sheath structure may include multiple parts, each of which can be moved separately to separately deploy various parts of the valve. The apparatus may have other aspects, such as the ability to reverse deployment of the valve, the ability to pass other instrumentation through the valve delivery apparatus, the ability to be smoothly withdrawn from the patient after deployment of the valve, etc.
In one embodiment, an irrigated catheter ablation apparatus comprises an elongated body having a distal end, a proximal end, and at least one fluid lumen extending longitudinally therein; and a plurality of segmented ablation electrodes on a distal portion of the elongated body. The electrodes are spaced from the proximal end and from the distal end of the elongated body by electrically nonconductive segments. The electrodes are spaced from each other longitudinally by electrically nonconductive segments. For each electrode that is longitudinally disposed next to one of the nonconductive segments, an edge is formed between an electrode end of the electrode and a nonconductive segment end of the nonconductive segment. A plurality of elution holes are disposed adjacent to the edges. A plurality of ducts establish fluid communication between the elution holes and the fluid lumen.
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
75.
STENT FEATURES FOR COLLAPSIBLE PROSTHETIC HEART VALVES
A prosthetic heart valve includes a stent (700) having an expanded condition and a collapsed condition. The stent includes a plurality of distal cells (702), a plurality of proximal cells (706), a plurality of support struts (704) coupling the proximal cells to the distal cells, and at least one support post (708) connected to a plurality of proximal cells. The proximal cells are longitudinally spaced apart from the distal cells. Various strut configurations and connections of the struts to the proximal cells and of the proximal cells to the support post improve stent flexibility and reduce stress in the valve leaflets.
A crimping tool (100) for use with a collapsible prosthetic (200) valve having a stent frame (202) with a plurality of cell openings (222), and a valve structure (234) assembled in the stent frame. The crimping tool includes a plurality of resilient tines (124) defining an array around a longitudinal axis of the crimping tool. The array has a first cross section in an expanded state and a second cross section less than the first cross section in a collapsed state. The plurality of tines are adapted to intersect the plurality of cell openings in an assembled position of the crimping tool on the prosthetic valve to prevent pinching of the valve structure by the stent frame as the prosthetic valve is collapsed.
A device for sealing a puncture in a patient includes a sealing component including an elongate control member configured to pass through a puncture in skin of a patient. The sealing component also includes an expandable member disposed near a distal end of the control member, and a tip releasably attached to the elongate control member distal to the expandable member. The device also includes a sealing material delivery component including a delivery tube through which the control member of the sealing component is configured to extend. The delivery tube is configured to deliver sealing material through an opening in a distal end of the delivery tube.
A support (100) for an adjustable annuloplasty ring (30) generally includes a body (10) and a groove (20). The body has a first end, a second end and an outer surface. The body may also include an inner surface defining a longitudinal bore (12). The outer surface is configured to slidably receive an annuloplasty ring and a length of adjustable suture (40). The groove is formed along at least a portion of the outer surface of the body and is dimensioned to receive at least a portion of the suture.
A61F 2/00 - Filtres implantables dans les vaisseaux sanguinsProthèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corpsAppareils pour les assujettir au corpsDispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p. ex. stents
The present invention relates to a medical device comprising both pyrolytic carbon and an NO generator, methods of making same, and methods of using same.
A heart valve annulus sizer (10) is provided for measuring a valve to be fitted with an annuloplasty ring. The sizer (10) may include a body (17) having a peripheral portion (18) defining an opening (18a), at least one rib (15) disposed within the opening (18a) and dividing the opening (18a) into at least a first opening (16) and a second opening (16), and an anchor (11) disposed on and projecting from the body (17). The sizer (10) may include a length of suture (75) connected to the body (17). The anchor (11) may include an aperture (11a) adapted to receive the length of suture (75). A method of using the sizer (10) is provided that includes grasping the sizer (10) with an instrument and positioning the sizer (10) adjacent to a valve into a position suitable to allow for measurement of the valve.
An introducer for providing access to the interior of the heart generally includes a valve, a shaft, and a piercing element. The valve has a substantially closed state in the absence of an instrument inside the valve and an open state in the presence of the instrument inside the valve. The shaft has first and second ends. The piercing element is located at the first end of the shaft. The shaft is removably positioned inside the valve in an assembled condition. The valve is dimensioned to receive the instrument therein upon removal of the shaft from the valve.
An apparatus comprising a blood vessel measuring device is disclosed. The blood vessel measuring device may comprise a handle. A measuring member may be attached to the handle. The measuring member may be dimensioned to wrap around a blood vessel to measure a size of the blood vessel. The blood vessel measuring device may comprise an extension, and a first end of the extension may be attached to the handle. The blood vessel measuring device may comprise a connector attached to a second end of the extension. A method is also disclosed. The method may comprise inserting a measuring device into an incision in a patient. The measuring device may comprise a measuring member. The method may also comprise wrapping the measuring member around a blood vessel of the patient and measuring a dimension of the blood vessel with the measuring member.
A system comprising a tube with a first end dimension to be positioned against a cardiovascular organ. The system may comprise a cutting member adapted to cut an opening in the cardiovascular organ. The system may also comprise a first valve positioned inside the tube. The first valve may be adapted to open to allow the cutting member to pass through the first valve to the cardiovascular organ. The first valve may be adapted to close after the cardiovascular coring device is retracted through the first valve. A cardiovascular coring apparatus is also disclosed. The cardiovascular coring apparatus may comprise a cutting member, a tissue retraction member, and a valve positioned inside the cutting member. A method for inserting a cutting member through a valve is disclosed. A method for inserting a tissue retraction member through a valve in a cutting member is also disclosed.
A cardiovascular valve assembly is disclosed including a housing assembly comprising a first portion and a second portion removably attached to the first portion. A valve may be positioned within the housing assembly. The valve, which may be a mechanical valve, a biological tissue valve, or a polymeric valve, may be structured to allow fluid to flow through the housing assembly in a single direction. In certain embodiments, the valve assembly may further include at least one coupling structure provided on the second portion and at least one aperture defined in the first portion, with the aperture structured to receive the coupling structure to couple the first portion to the second portion. Corresponding systems incorporating cardiovascular valve assemblies are also disclosed.
A cardiovascular conduit (20) system may comprise a connector (28). The connector may comprise a proximal end (104) adapted to attach to a cardiovascular organ. The proximal end may comprise a first plurality of expandable members (110), 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 (102) adapted to attach to a conduit and an opening (108) 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.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour réaliser l'anastomoseBoutons pour anastomose
A cardiovascular valve assembly is disclosed including a housing assembly comprising a first portion and a second portion removably attached to the first portion. A valve may be positioned within the housing assembly. The valve, which may be a mechanical valve, a biological tissue valve, or a polymeric valve, may be structured to allow fluid to flow through the housing assembly in a single direction. In certain embodiments, the valve assembly may further include at least one coupling structure provided on the second portion and at least one aperture defined in the first portion, with the aperture structured to receive the coupling structure to couple the first portion to the second portion. Corresponding systems incorporating cardiovascular valve assemblies are also disclosed.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour réaliser l'anastomoseBoutons pour anastomose
A61B 17/115 - Agrafeuses pour réaliser une anastomose, p. ex. en une seule opération
A system (1000, 2000, 3000, 4000, 5000) for delivering a medical implant (10) includes an expandable member (30, 150) at least partially positioned inside the medical implant and operable to radially expand at least a portion of the medical implant to an expanded condition, first and second grasping mechanisms (100) each adapted to grasp a portion of the medical implant, and a displacement mechanism (170) operatively coupled to the first and second grasping mechanisms and configured to move the first and second grasping mechanisms between an inner position in which the first and second grasping mechanisms are relatively close to one another, and an outer position in which the first and second grasping mechanisms are relatively distant to one another. The movement of the first and second grasping mechanisms from the outer position to the inner position at least partially collapses the medical implant from the expanded condition to enable the medical implant to be repositioned if necessary.
An ablation and monitoring system comprises a catheter, an optical coherence tomography (OCT) system, and an ablation generator. The catheter comprises one or more optical fibers to transmit a light beam to a tissue material and collect a reflected light from the tissue material. The OCT system is in optical communication with the catheter via the one or more optical fibers, providing the light beam to the one or more optical fibers and receiving the reflected light from the one or more optical fibers. The ablation generator is in electrical communication with the OCT system and with the catheter. The ablation generator provides radio frequency energy to the catheter for ablating the tissue material, monitors and assesses the ablation based on an information signal received from the OCT system.
A catheter system for wireless communication with an electrophysiological (EP) mapping system. The catheter system comprises a catheter, a catheter adapter, and a radio frequency receiver module. The catheter includes a plurality of mapping electrodes including a tip electrode disposed on a distal portion of the elongated body, the mapping electrodes detecting electrocardiograph (ECG) signals; and a reference electrode being disposed on the elongated body at a distance from the plurality of mapping electrodes such that the reference electrode substantially does not detect electrocardiograph signals. The catheter includes a handle. The catheter adapter is attached to the handle. The catheter adapter includes an RF transmitter module for receiving, processing, and transmitting the detected ECG signals. The reference electrode provides a reference signal to the radio frequency (RF) transmitter module. The RF receiver module receives the transmitted ECG signals. The RF receiver module is coupled to the EP mapping system.
A stent (10) for use in a prosthetic heart valve has an annulus section (12) adapted for placement within the ' leaflets and annulus of the native heart valve. The annulus section has latch members (50) adapted to engage the leaflets of the native heart valve when prosthetic valve is implanted in the native valve. The latch members may hold the leaflets in engagement with the annulus section, and help to retain the prosthetic valve in position. The annulus section may have a non-circular cross-sectional shape.
A prosthetic heart valve is provided with a cuff (85, 285, 400) having features which promote sealing with the native tissues even where the native tissues are irregular. The cuff may include a portion (90) adapted to bear on the LVOT when the valve is implanted in a native aortic valve. The valve may include elements (210, 211, 230, 252, 253) for biasing the cuff outwardly with respect to the stent body when the stent body is in an expanded condition. The cuff may have portions of different thickness (280) distributed around the circumference of the valve in a pattern matching the shape of the opening defined by the native tissue. All or part (402) of the cuff may be movable relative to the stent during implantation.
A system for delivering a collapsible and re-expandable prosthetic heart valve into a patient includes a valve support structure (140) around which the valve (10) is disposed in a collapsed condition. A sheath structure (110) surrounds the collapsed valve, but can be moved relative to the valve to uncover it for expansion at the desired implant site in the patient. The sheath structure may be variously mounted and moved to deploy the valve in various ways. For example, the sheath structure may include multiple parts, each of which can be moved separately to separately deploy various parts of the valve. The apparatus may have other aspects, such as the ability to reverse deployment of the valve, the ability to pass other instrumentation through the valve delivery apparatus, the ability to be smoothly withdrawn from the patient after deployment of the valve, etc.
A frame structure for a collapsible and re- expandable prosthetic heart valve. The frame structure includes an annular annulus portion that is configured for implanting in or near a patient's native heart valve annulus. This annulus portion of the frame structure may include a plurality of annularly spaced commissure post structures interconnected by connecting structures. The commissure post structures may be more resistant to annular collapse than the connecting structures. In the case of a prosthetic aortic valve, the frame structure may also include an annular aortic portion. The aortic portion may include a plurality of attachment points (for tethers) closest to the annulus portion. Such attachment points and tethers can facilitate re-collapse of a partly deployed valve in the event of a need to reposition or remove the valve.
A prosthetic heart valve includes an annular stent structure having a plurality of annularly spaced stent post regions, a plurality of leaflets that extend radially inward from the stent structure and that include radially outer portions that lie against a radially outer surface of the stent structure, and a clamping structure that is radially outside the other components and that clamps the radially outer portions of the leaflets against the radially outer surface of the stent structures to secure the leaflets to the stent structure. The above-described structural arrangement applies to the stent post regions as well as to other portions of the stent structure.
A prosthetic heart valve is circumferentially collapsible for less invasive delivery into a patient. The valve re-expands to operating size at the implant site in the patient. A frame structure of the valve includes restraining structure that can help to push one or more of the patient's native heart valve leaflets radially outwardly so that this native leaflet tissue does not interfere with the operation or service life of the prosthetic valve.
Prosthetic heart valve apparatus is adapted for delivery into a patient in a circumferentially collapsed condition, followed by circumferential re-expansion at the implant site in the patient. The apparatus includes an annular anchoring structure that can be implanted in the patient first. The apparatus further includes an annular valve support structure, which supports a flexible leaflet structure of the valve. The support and leaflet structures are initially separate from the anchoring structure, but they can be implanted in the patient by interengagement of the support structure with the already-implanted anchoring structure.
A prosthetic heart valve is designed to be circumferentially collapsible for less invasive delivery into the patient. At the implant site the valve re-expands to a larger circumferential size, i.e., the size that it has for operation as a replacement for one of the patient's native heart valves. The valve includes structures that, at the implant site, extend radially outwardly to engage tissue structures above and below the native heart valve annulus. These radially outwardly extending structures clamp the native tissue between them and thereby help to anchor the prosthetic valve at the desired location in the patient.
Prosthetic heart valves, which are collapsible to a relatively small circumferential size for less invasive delivery into a patient and which then re-expand to operating size at an implant site in the patient, include a collapsible/expandable stent-like supporting structure and various components of flexible, sheet-like material that are attached to the supporting structure. For example, these sheet-like other components may include prosthetic valve leaflets, layers of buffering material, cuff material, etc. Improved structures and techniques are provided for securing such other components to the stent-like supporting structure of the valve.
A structure for use as a prosthetic heart valve leaflet includes a two-dimensional array that is made up of one or more fiber strands and that is covered by a web of polymer material to produce a sheet that is impervious to blood. This sheet is stretchable along two axes that lie in the plane of the sheet and that are at an angle to one another. The sheet may be more easily stretched along one of these axes than along the other axis. Along each axis the amount of force required to produce initial increments of stretch may be less than the amount of force required to produce subsequent increments of stretch (i.e., increments of stretch beyond the initial increments).
A prosthetic aortic valve includes an annular, annulus inflow portion that is designed to reside in or near the patient's native aortic valve annulus, and an annular, aortic outflow portion that is designed to reside in the patient's aorta downstream from at least a portion of the valsalva sinus. The annulus inflow portion and the aortic outflow portion are connected to one another by a plurality of connecting struts that are confined to regions near the commissures of the patient's native aortic valve. The connecting struts are designed to bulge out into the valsalva sinus to help anchor the prosthetic valve in place. The valve is circumferentially collapsible to a relatively small diameter for less-invasive delivery into the patient. The valve circumferentially expands to a larger operational diameter when deployed at the implant site.
