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The invention concerns an assembly comprising a valve prosthesis to be implanted and a support receiving said valve. The support comprises: at least a tubular portion made of a pliable material slightly stretchable in the circumferential direction; means for fixing said tubular portion to the wall of the corporeal duct; and a plurality of elongated reinforcing elements, arranged on the circumference of said tubular portion and linked to said tubular portion independently of one another; the valve is linked at least partly to said elongated reinforcing elements, in particular at the commissures of its leaflets, and said elongated reinforcing elements jointly form, in extended position, a structure having a predetermined diameter that ensures sufficient extension of said valve.

Apparatus and methods provide distal protection while accessing blood vessels within a patient's vasculature. A flexible sheath and distal protection element, e.g., a balloon or filter, are carried by a stiffening member. The sheath is lubricious and has a relatively thin wall, thereby providing a collapsible/expandable guide for delivering fluids and/or instruments. The sheath is advanced into a blood vessel in a contracted condition, expanded to an enlarged condition to define a lumen, and the distal protection element is deployed within the vessel beyond the sheath. Fluids and/or instruments are introduced into the vessel via the sheath lumen, the distal protection element retaining the fluids and/or capturing emboli released by the instruments. Upon completing the procedure, the sheath, distal protection element, and stiffening member are removed from the vessel.

A golf club comprising a head having a series of tracks forming a three-dimensional pattern along a surface of the head; a plurality of weights for positioning along the channels; and a mechanism for securing the weights at arbitrary positions along the channels so as to customize at least one of center of gravity and moment of inertia of the head. The channels can all interconnect with one another to allow a weight to be moved from one to another. The golf club can further comprising a removable cover for at least a portion of the surface, the cover being for covering the channels and the weights positioned along the channels. The weights can comprise a spherical member disposed in a channel; an external member having a portion external to a surface of the head; and a coupling between the spherical member and the external member to allow the spherical member and the external member to securely capture between them a wall in which a track is formed. The channels may be in the removable cover, or below the removable cover, in the head.

Devices, systems and methods useable for dilating the ostia of paranasal sinuses and/or other passageways within the ear, nose or throat. A dilation catheter device and system is constructed in a manner that facilitates ease of use by the operator and, in at least some cases, allows the dilation procedure to be performed by a single operator. Additionally, the dilation catheter device and system may be useable in conjunction with an endoscope and/or a fluoroscope to provide for easy manipulation and positioning of the devices and real time visualization of the entire procedure or selected portions thereof. In some embodiments, an optional handle may be used to facilitate grasping or supporting a device of the present invention as well as another device (e.g., an endoscope) with a single hand.

A system and method is provided for treating a mitral valve. The method preferably includes advancing a guide catheter to an ostium of the coronary sinus and advancing a delivery catheter containing a medical implant through the guide catheter and into the coronary sinus. The delivery catheter has an inner member on which the medical implant is held and an outer sheath which is retractable for deploying and releasing the medical implant. In one embodiment, the medical implant has proximal and distal anchors and a bridge containing resorbable material. The inner member may have a flexible sleeve for gripping and holding a portion of the outer sheath, thereby providing a releasable attachment mechanism. In another embodiment, the inner member may include an inflatable balloon having a tapered distal region which extends from the outer sheath for providing an atraumatic tip. The inflatable balloon may also be used to expand the medical implant and to grip the outer sheath.

Methods, devices and systems facilitate diagnosis, and in some cases treatment, of back pain originationg in intervertebral discs. Methods generally involve introducing one or more substances into one or more discs using a catheter device. In one embodiments, a patient assumes a position that causes back pain, and a substance such as an anesthetic or analgesic is introduced into the disc to determine whether the substance relieves the pain. Injections into multiple discs may optionally be performed, to help pinpoint a disc as a sources of the patient's pain. In some embodiments, the catheter device is left in place, and possibly coupled with another implantable device, to provide treatment of one or more discs. A catheter device includes at least one anchoring member for maintaining a distal portion of the catheter within a disc.

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

Methods and apparatus are provided for treating congestive heart by actively or passively enhancing perfusion to the renal arteries. A first embodiment comprises a specially configured balloon catheter and extracorporeal pump, wherein the pump operates in a “once-through” fashion or alternating volume displacement mode. In another embodiment the catheter includes a pair of balloons to isolate a region of the aorta, and a third balloon that directs flow into the renal arteries. In still further embodiments, a stent or cuff having a constricted region is deployed in or around the aorta, respectively, to create a backpressure upstream of the stent or cuff. Methods of enhancing renal perfusion also are provided.

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

The invention relates to a method for the isolation of hepatitis C virus. The method comprises the separation of particles termed exosomes from the blood plasma of an individual infected with hepatitis C virus (HCV) and the extraction or RNA from these exosome particles.

Apparatus is provided for use with at least one tissue-adjustment device, including a tissue-engaging element having a distal portion configured to engage at least a first portion of tissue of a patient, and having a proximal portion. At least one docking station is coupled to the proximal portion of the tissue-engaging element and is configured to be coupled to the at least one tissue-adjustment device. The docking station includes a locking mechanism configured to lock the tissue-adjustment device to the tissue-engaging element. At least one guide member is reversibly coupled to the at least one docking station and is configured for facilitating slidable advancement of the at least one tissue-adjustment device toward the tissue-engaging element. Other applications are also described.

The invention is related to methods of sizing an area around the pulmonary veins along an epicardial surface. A sizing element is provided which has a plurality of indicators along its length which is used to size an area around the pulmonary veins. A sizing element is wrapped around the pulmonary veins along an epicardial location. The size of an ablating device is determined by using the indicators on the sizing element. An ablating device is then selected based on this measurement. The ablating device is then attached to the sizing element. The ablating device is then wrapped around the pulmonary veins while manipulating the sizing element.

A device is provided to assist in closing an incision through body tissue that comprises a tubular body sized for introduction through the incision and carrying a plurality of stabilizer elements at the distal end thereof. The stabilizer elements are configured to be deployed within the body cavity to engage the lowermost tissue layer. In one method, the device is pulled with the stabilizer elements deployed to retract the body tissue away from adjacent body structure. In another method, a plurality of needle tips carrying sutures are guided through the body tissue to a retention device at the ends of the stabilizer elements. With the needle tips captured in the retention devices, the device is withdrawn from the incision so that the sutures form ligatures that can be tied off to close the incision.

Apparatus is provided, comprising (1) a guide member, (2) a tissue-adjustment mechanism having (a) an upper surface and a lower surface, (b) at least one first opening at the upper surface, (c) at least one second opening at the lower surface, and (4) a channel extending between the first and second openings, the channel facilitating advancement of the tissue-adjustment mechanism along the guide member; and (3) at least one repair chord coupled at a first portion thereof to the tissue-adjustment mechanism and having at least a first end that is configured to be coupled to a portion of tissue of a patient, the repair chord being configured to adjust a distance between the portion of tissue and the tissue-adjustment mechanism, in response to adjustment of the repair chord by the tissue-adjustment mechanism. Other embodiments are also described.

An ocular implant is provided that is adapted to reside at least partially in a portion of Schlemm's canal of an eye. The implant includes an implant body having plurality of filars extending along a longitudinal axis of the implant. The implant is configured to move between a radially collapsed state and a radially expanded state. In some embodiments, the implant is configured to assume the radially expanded state when no external forces are acting thereon. Methods of delivering and using the ocular implant are also provided.

Expandable laser catheters for utilizing laser energy to remove obstructions from body passages are described. In one embodiment, the laser catheter includes a shaftway having a distal end including a flexible portion configured in a series of radial folds. Multiple optical fibers, configured to transmit laser energy, extend along the shaftway and are attached to the flexible portion. An inflatable, ring-shaped balloon is attached to the catheter within the flexible portion. In use, the catheter is inserted into a body passage such as an artery, and advanced until the distal end is adjacent to an obstruction. The balloon is inflated to expand the flexible portion and to bring the optical fibers nearer the inner wall of the body passage. Laser energy is directed by the optical fibers toward targeted regions of the obstruction. As the catheter is advanced and the process repeated, a core is formed from the obstruction and contained within the flexible portion. The flexible portion is then contracted to hold the core, and the core is removed from the body passage by withdrawing the catheter.

Methods and devices for treating defective heart valves are disclosed herein. In one exemplary embodiment, a transcatheter heart valve includes an expandable shape memory stent and a valve member supported by the stent. A plurality of micro-anchors can be disposed along an outer surface of the stent for engaging native tissue. The transcatheter heart valve can be configured to be advanced into a dilated valve annulus via a balloon catheter. The balloon can be inflated to expand the transcatheter heart valve from a collapsed diameter to an over-expanded diameter such that the micro-anchors engage tissue along the surrounding valve annulus. After engaging the tissue, the balloon can be deflated and the shape memory stent can retract or recoil toward its predetermined recoil diameter. As the stent recoils, the surrounding tissue is pulled inward by the stent such that the diameter of the valve annulus is reduced.