Implantable medical device having a linker, medical snare instrument, and methods thereof

Abstract

An implantable medical device that includes first and second components, and a linker that links first and second components. The linker being for the implantable medical device to forcedly change between first and second configurations. A method of using the implantable medical device. A medical snare instrument for capturing an implantable medical device. The medical snare instrument includes a first elongated body associated with a capture element configured to be converted between non-capturing and capturing configurations, and a second elongated body with projecting and terminal end portions configured to project beyond the first elongated body. The first elongated body and / or the terminal end portion being configured to be moved for converting the capture element between the non-capturing and capturing configurations. A method of using a medical snare instrument to capture a medical device.

Description

[0001] IMPLANTABLE MEDICAL DEVICE HAVING A LINKER, MEDICAL SNARE INSTRUMENT, AND METHODS THEREOF

[0002] FIELD

[0003] [1] This disclosure relates to an implantable medical device having a linker, a medical snare instrument, and methods thereof.

[0004] BACKGROUND

[0005] [2] Implantable medical devices have revolutionized modem medicine by providing effective solutions for treating a wide range of medical conditions. Among these devices, transcatheterly implantable medical devices stand out as minimally invasive alternatives to traditional surgical implants, offering shorter recovery times and reduced procedural risks. Such devices may be designed as two or more components thereof that are assemblable together and / or unassemblable from each other in vivo.

[0006] [3] On one hand, the successful use of transcatheterly implantable medical devices in narrow and / or tortuous anatomical structures, such as those with acute angles or multiple curves, present significant challenges. The vascular system is a typical example of a narrow and / or tortuous lumen with complex pathways. Anatomical variations, including vessel narrowing, calcification, and acute angulations can impede or prevent the use of transcatheterly implantable medical devices and increase the risk of procedural complications.

[0007] [4] These challenges are compounded when, for example, the transcatheterly implantable medical device is required to be precisely positioned and / or anchored, as slight deviations can potentially lead unwanted outcomes. Using a transcatheterly implantable medical device in an angled blood vessel, such as adjacent or in the aortic arch, may require a balance of flexibility and rigidity of the device to be used appropriately in vivo. Mispositioning and / or misaligning the transcatheterly implantable medical device may result in the implantable medical device abutting the lumen wall, hindering or preventing its appropriate operation or functioning. This may also be the case for non-transcatheterly implantable medical devices. [5] On the other hand, medical practitioners performing transcatheter or other interventional approaches may face significant challenges when attempting to capture medical devices, such as transcatheterly implantable medical devices, using a medical snare instrument.

[0008] [6] For example, tortuous cardiovascular anatomies may create restricted access angles and limited maneuvering space, making it difficult to advance, orient, and stabilize the medical snare instrument relative to the implanted medical device. The implanted medical device may be malpositioned at its implantation site — for instance, pressing against an anatomical structure such as a lumen wall — which can hinder or prevent capture of the implanted medical device by the medical snare instrument. The implanted medical device may also have unintentionally migrated from its intended implantation site to a more challenging anatomical location. Such conditions are typically exacerbated in the context of more complex medical interventions.

[0009] [7] In transcatheter and other interventional approaches, ease of manipulation of the medical snare instrument is generally desirable, for example by enabling a medical practitioner to operate the medical snare instrument with a single hand, thereby allowing the practitioner to use the other hand for additional tasks.

[0010] [8] Therefore, there is one or more ongoing needs in the field of implantable medical devices and medical snare instruments.

[0011] SUMMARY

[0012] [9] An aspect on this disclosure is directed to an implantable medical device, including: a first implantable medical device component having a first end portion and a second end portion; a second implantable medical device component having a first end portion and a second end portion; and a linker configured to link the first end portion of the first implantable medical device component and the second implantable medical device component together, wherein the linker is further configured for the implantable medical device to change between a first configuration and a second configuration when a force is applied to at least one of the first implantable medical device component and the second implantable medical device component.

[0010] Another aspect on this disclosure is directed to a method of implanting a medical device in a subject’s body, the medical device including a first implantable medical device component, a second implantable medical device component, and a linker linking the first implantable medical device component and the second implantable medical device component together, the method including: implanting the medical device in the subject’s body to cause the linker to change the implantable medical device from a first configuration to a second configuration.

[0013]

[0011] Another aspect on this disclosure is directed to a method of explanting a medical device from a subject’s body, the medical device including a first implantable medical device component, a second implantable medical device component, and a linker linking the first implantable medical device component and the second implantable medical device component together, the method including: explanting the medical device from the subject’s body to cause the linker to change the implantable medical device from a first configuration to a second configuration.

[0014]

[0012] Another aspect on this disclosure is directed to a medical snare instrument for capturing an implantable medical device, the medical snare instrument including: a first elongated body; a capture element associated with the first elongated body and configured to be converted between a non-capturing configuration and a capturing configuration, the capturing configuration being for capturing the implantable medical device; and a second elongated body including a projecting end portion configured to project beyond the first elongated body, the projecting end portion including a terminal end portion, wherein at least one of the first elongated body and the terminal end portion is configured to be moved toward the other one of the first elongated body and the terminal end portion for converting the capture element between the non-capturing configuration and the capturing configuration.

[0015]

[0013] Another aspect on this disclosure is directed to a method of using a medical snare instrument to capture a medical device implanted in a subject’s body, the medical snare instrument including a first instrument portion and a second instrument portion that projects beyond the first instrument portion, the method including: establishing a magnetic interaction between the second instrument portion of the medical snare instrument and the medical device; and moving at least one of the first instrument portion and the second instrument portion toward the other one of the first instrument portion and the second instrument portion to capture the medical device.

[0014] The skilled addressee will recognize that one or more embodiments can be combined, in whole or in part, as the case may be. Features and advantages of the disclosed subject-matter will become apparent in view of the following detailed description of selected embodiments, as illustrated in the accompanying drawings.

[0016] BRIEF DESCRIPTION OF THE DRAWINGS

[0017]

[0015] In order that this disclosure be readily understood, at least some selected embodiments thereof are illustrated by way of example(s) in the accompanying drawings. Accordingly, the accompanying drawings and figures are illustrative in nature only and are not intended to be construed and interpreted as limiting the extent of the subject matter protected by the claims. Similarly, any text that might appear in any drawings and figures is illustrative in nature only and is not intended to necessitate that any particular component needs to be included in the embodiment.

[0018]

[0016] It is noted that like reference characters identify similar or equivalent feature(s) throughout the drawings. If present in the claims, reference character(s) is / are provided only to make claims easier to comprehend and are not intended to be construed and interpreted as limiting the extent of the subject matter protected by the claims. Also, the features illustrated throughout the drawings are not necessarily drawn to scale. To help understand the drawings and figures, feature(s) that may be optional to the technology disclosed may be represented in dashed lines.

[0019]

[0017] FIG. 1 is a schematic representation of an implantable medical device provided with a linker, and optionally including an assemblable medical device, in accordance with an aspect of this disclosure. The implantable medical device may optionally include multiples assemblable medical devices.

[0020]

[0018] FIGS. 2-3 are schematic representations of an implantable medical device, such as one of FIG. 1, at least partially implanted in an aorta of a subject’s body, in accordance with one or more embodiments.

[0021]

[0019] FIGS. 4-5 are schematic representations of an implantable medical device, such as one of FIG. 1, at least partially implanted in through the left ventricle of a subject’s body, in accordance with one or more embodiments.

[0020] FIG. 6 is a perspective view of an implantable medical device, such as one of FIG. 1, in accordance with one or more embodiments.

[0022]

[0021] FIG. 7 is a perspective view of a second implantable medical device component of the implantable medical device of FIG. 6 that is assembled to three optional assemblable medical devices, in accordance with one or more embodiments.

[0023]

[0022] FIG. 8 is a perspective view of an end portion of a first implantable medical device component of the implantable medical device of FIG. 6 having an end portion of an optional assemblable medical device superposed to it for the sake of clarity, in accordance with one or more embodiments. The double-headed arrow indicates a possible movement of the end portion of the optional assemblable medical device.

[0024]

[0023] FIG. 9 is a perspective view of the second implantable medical device component of the implantable medical device of FIG. 7 with the three optional assemblable medical devices having various configurations, in accordance with one or more embodiments.

[0025]

[0024] FIG. 10 is a perspective view of the first implantable medical device component of the implantable medical device of FIG. 8 having an end portion that is optionally atraumatic and optionally removable, in accordance with one or more embodiments.

[0026]

[0025] FIG. 11 is a perspective view of the first implantable medical device component of the implantable medical device of FIG. 10 having the end portion optionally removed, in accordance with one or more embodiments.

[0027]

[0026] FIG. 12 is a perspective view of the second implantable medical device component of the implantable medical device of FIG. 7 without any assemblable medical device, in accordance with one or more embodiments.

[0028]

[0027] FIG. 13 is a top view of the second implantable medical device component of the implantable medical device of FIG. 7 without any assemblable medical device, in accordance with one or more embodiments.

[0029]

[0028] FIGS. 14-15 are perspective views of another second implantable medical device component of an implantable medical device, such as one of FIG. 1, without or with three assemblable medical devices assembled to the second implantable medical device component, respectively, in accordance with one or more embodiments.

[0030]

[0029] FIGS. 16-17 are perspective views of another second implantable medical device component of an implantable medical device, such as one of FIG. 1, without or with three assemblable medical devices assembled to the second implantable medical device component, respectively, in accordance with one or more embodiments.

[0031]

[0030] FIG. 18 is a side view of another second implantable medical device component of an implantable medical device, such as one of FIG. 1, without any assemblable medical device, in accordance with one or more embodiments. The remaining components of the implantable medical device are omitted in FIG. 18.

[0032]

[0031] FIGS. 19-22 are perspective views of another second implantable medical device component of an implantable medical device, such as one of FIG. 1, that is provided with three optional assemblable medical devices, in accordance with one or more embodiments.

[0033]

[0032] FIGS. 23-24 are photographs of an implantable medical device, such as one of FIG. 1, without and with optional assemblable medical devices, respectively, that is at least partially implanted in a descending aorta and a left subclavian artery of a mock anatomical vascular system, in accordance with another aspect of this disclosure and one or more embodiments.

[0034]

[0033] FIGS. 25-26 are schematic representations of methods of implanting and explanting, respectively, an implantable medical device, such as one of FIG. 1, in accordance with another aspect of this disclosure and one or more embodiments.

[0035]

[0034] FIG. 27 is a schematic representation of a medical device implanted at an example challenging implantation site within a subject’s cardiovascular system, where a capturable portion of the implantable medical device is pressed against a lumen wall.

[0036]

[0035] FIG. 28 is a schematic representation of a medical snare instrument for capturing an implantable medical device, in accordance with another aspect of this disclosure.

[0037]

[0036] FIG. 29 is a side perspective view of a medical snare instrument, such as one of FIG. 28, in accordance with an embodiment of this disclosure.

[0037] FIG. 30 is an enlarged longitudinal sectional view of the medical snare instrument of FIG. 29 with a capture element in a non-capturing configuration, in accordance with an embodiment of this disclosure.

[0038]

[0038] FIG. 31 is a view of an end portion of the medical snare instrument of FIG. 29, in accordance with an embodiment of this disclosure. Some components of the medical snare instrument are omitted for clarity reason.

[0039]

[0039] FIG. 32 is an enlarged longitudinal sectional view of the medical snare instrument of FIG. 29 with capture projections along an outer peripheral portion of the medical snare instrument, in accordance with an embodiment of this disclosure.

[0040]

[0040] FIG. 33 is an enlarged longitudinal sectional view of the medical snare instrument of FIG. 29 with a capture element in a capturing configuration, in accordance with an embodiment of this disclosure.

[0041]

[0041] FIG. 34 is an enlarged longitudinal sectional view of the medical snare instrument of FIG. 29 with a wire along an outer peripheral portion of the medical snare instrument, in accordance with an embodiment of this disclosure.

[0042]

[0042] FIGS. 35-37 are enlarged longitudinal sectional views of an operator handle of the medical snare instrument of FIG. 29, in accordance with an embodiment of this disclosure. Some components of the medical snare instrument are omitted in each of them for clarity reason.

[0043]

[0043] FIG. 38 is a side view of the medical snare instrument of FIG. 29 where the medical snare instrument is provided with a sheath loader, in accordance with an embodiment of this disclosure.

[0044]

[0044] FIG. 39 is a schematic representation of a method of using a medical snare instrument, such as one of FIG. 28, in accordance with another aspect of this disclosure.

[0045] DETAILED DESCRIPTION

[0046]

[0045] The subject matter of this disclosure is described and explained in the following detailed description with reference to the non-limiting aspect(s), embodiment(s), example(s), feature(s), element(s), and step(s), as the case may be, presented hereinafter and illustrated in the accompanying non-limiting drawings and / or figures. Recognizing that these may vary, the skilled addressee shall readily understand that any other variants thereof and any combination of these other variants, as the case may be, are contemplated without departing from the scope of this disclosure, even if they are all not explicitly presented and stated herein.

[0047]

[0046] Therefore, these non-limiting aspect(s), embodiment(s), example(s), feature(s), and / or element(s) is / are intended merely to facilitate an understanding of ways in which the claimed subject matter may be reduced to practice by the skilled addressee. Accordingly, these shall not to be construed as limiting the scope of the claimed subject matter, which is defined solely by the accompanying claims and applicable law.

[0048]

[0047] The terminology used herein is only for the purposes of describing and explaining the claimed subject matter and is not intended to limit the scope hereof. Unless defined otherwise, all technical, engineering, scientific, and other relevant terminology used herein have the same meanings as commonly understood by the skilled addressee.

[0049] Implantable Medical Device Having a Linker

[0050]

[0048] With the foregoing in mind, as schematically represented in FIG. 1, this disclosure relates to an implantable medical device 100 that includes a first implantable medical device component 102 having a first end portion and a second end portion, a second implantable medical device component 104 having a first end portion and a second end portion, and a linker 106 configured to link the first end portion of the first implantable medical device component 102 and the second implantable medical device component 104 together, according to an aspect of this disclosure. The linker 106 is further configured for the implantable medical device 100 to change, convert, or transition between a first arrangement and a second arrangement when a force is applied to at least one of the first implantable medical device component 102 and the second implantable medical device component 104.

[0051]

[0049] The first arrangement may be an arrangement in which the first implantable medical device component 102 and the second implantable medical device component 104 are linearly arranged relative to each other, as illustrated, for example, in FIG. 6, according to one or more embodiment(s). The second arrangement may be an arrangement in which the first implantable medical device component 102 and the second implantable medical device component 104 are non-linearly arranged relative to each other, as illustrated, for example, in FIGS. 23-24, according to one or more embodiment s). FIGS. 2-3 schematically illustrate the first implantable medical device component 102 and the second implantable medical device component 104 in a nonlinear arrangement relative to each other, and FIGS. 4-5 also schematically illustrate the first implantable medical device component 102 and the second implantable medical device component 104 in a nonlinear arrangement relative to each other, but to a lesser extent as compared to FIGS. 2-3.

[0052]

[0050] The linker 106 is configured to flex, bend, articulate, pivot, hinge, and / or swivel such that the first implantable medical device component 102 and / or the second implantable medical device component 104 may be positioned for the implantable medical device 100 to be used appropriately in vivo, such as when the implantable medical device 100 is introduced, routed, navigated, delivered, anchored, assembled, operated, and / or implanted in vivo, as well as when the implantable medical device 100 is unassembled, unanchored, retrieved, externalized, and / or explanted in vivo. The implantable medical device 100 may include any transcatheterly and / or percutaneously implantable medical device.

[0053]

[0051] The first implantable medical device component 102 may be configured to run in a subject’s body, such as along in a lumen thereof; and the second implantable medical device component 104 may be configured to be anchored in a subject’s body and / or may be configured to be electrically or mechanically operated in a subject’s body. As such, the first implantable medical device component 102 may be referred to herein as an “elongated medical device”, and the second implantable medical device component 104 may be referred to herein as an “anchorable and / or operable medical device”.

[0054]

[0052] The second implantable medical device component 104 may be electrically or mechanically operated through the linker 106 and / or the first implantable medical device component 102 by a controller operatively connected to the first implantable medical device component 102. Alternatively, the second implantable medical device component 104 optionally include a power lead 108 (represented in dashed lines in FIG. 1 as optional) configured to run along (as represented) or through both the linker 106 and the first implantable medical device component 102, and configured to operatively connect the controller for electrically or mechanically operating the second implantable medical device component 104. For example, the power lead 108 may be an electrical lead configured to electrically operate the second implantable medical device component 104 through it, or may be a driveshaft for mechanically operating the second implantable medical device component 104 through it. The second implantable medical device component 104 may be intracorporeally operated in a subject’s body by the controller extracorporeally located outside the subject’s body. The second implantable medical device component 104 may also be operated manually by an operator.

[0055]

[0053] Still referring to FIG. 1, the implantable medical device 100 may optionally include an assemblable medical device 110 (represented in dashed lines in FIG. 1 as optional) provided with a functional unit 112 and an elongated control structure 114 that projects therefrom, according to one or more embodiment s). The implantable medical device 100 may also optionally include multiple assemblable medical devices 110, as described herein. The functional unit 112 is configured to assemble to and unassemble from the second implantable medical device component 104 (as illustrated), the first implantable medical device component 102, and / or the linker 106.

[0056]

[0054] The elongated control structure 114 may be configured to be manipulated or actuated for assembling the functional unit 112 to and for unassembling the functional unit 112 from the second implantable medical device component 104. The elongated control structure 114 may further be configured to be positioned along or through the first implantable medical device component 102, the second implantable medical device component 104, and / or the linker 106. As such, the elongated control structure 114 may be in a slidable relationship with the first implantable medical device component 102, the second implantable medical device component 104, and / or the linker 106 for assembling and unassembling the functional unit 112.

[0057]

[0055] Manipulation or actuation of the elongated control structure 114 moves the functional unit 112 toward the first implantable medical device component 102, the second implantable medical device component 104, and / or the linker 106 for assembling the functional unit 112 to at least one of these. Manipulation or actuation of the elongated control structure 114 moves the functional unit 112 away from the first implantable medical device component 102, the second implantable medical device component 104, and / or the linker 106 for unassembling the functional unit 112 from at least one of these. Such movement of the functional unit 112 is indicated by a doubleheaded arrow in FIG. 1.

[0056] Accordingly, pulling the elongated control structure 114 away from the first implantable medical device component 102 moves the functional unit 112 towards the second implantable medical device component 104, causing the functional unit 112 to assemble thereto. Conversely, pushing the elongated control structure 114 toward the first implantable medical device component 102 moves the functional unit 112 away from the second implantable medical device component 104, causing the functional unit 112 to unassemble therefrom. The assembling and unassembling of the functional unit 112 and the implantable medical device 100 may be commanded from inside or outside the subject’s body. For example, the functional unit 112 may be intracorporeally assembled and intracorporeally unassembled in a subject’s body by manipulation by an operator or actuation of a portion of the elongated control structure 114 that is extracorporeally disposed outside the subject’s body.

[0058]

[0057] Therefore, the assemblable medical device 110 is intracorporeally convertible between an assembled configuration and an unassembled configuration. In the assembled configuration, the functional unit 112 and at least one of the second implantable medical device component 104 (as represented), the first implantable medical device component 102, and / or the linker 106 are assembled together. In the unassembled configuration, the functional unit 112 and at least one of the second implantable medical device component 104 (as represented), the first implantable medical device component 102, and / or the linker 106 are unassembled from each other.

[0059]

[0058] The assemblable medical device 110 may be configured for the functional unit 112 to be electrically or mechanically operated through the elongated control structure 114 by a controller (not shown) operatively connected to the elongated control structure 114. For example, the elongated control structure 114 may be an electrical lead configured to electrically operate the functional unit 112 through it by the controller, or may be a driveshaft configured to mechanically operate the functional unit 112 through it by the controller. The assemblable medical device 110 may also be configured for the functional unit 112 to be manually operated through the elongated control structure 114 by an operator (not shown). The functional unit 112 may be intracorporeally operated, in the assembled and unassembled configurations, in a subject’s body by the controller located outside or inside the subject’s body.

[0059] As described hereinbefore, the linker 106 is flexible (also referred to herein as a “flexible linker 106”), for example by being capable to be bent or modified without breaking and / or by being capable to adapt shape under force. The linker 106 may be also compliant (also referred to herein as a “compliant linker 106”), for example by being capable of yielding or deforming under force. The linker 106 may be also resilient (also referred to herein as a “resilient linker 106”), for example by being able to absorb energy when deformed and return to original shape without rupture or permanent deformation. The linker 106 may be also deformable (also referred to herein as a “deformable linker 106”), for example by being able to capable of undergoing a shape change under force. As such, the linker 106 may be flexible, compliant, resilient, and / or deformable.

[0060]

[0060] Additionally, the linker 106 may be changed, converted or transitioned from a first arrangement toward a second arrangement and be biased or overcomeably biased toward the first arrangement, which may include any linear, arced, angular, curved, and / or folded arrangements. For example, the linker 106 may have one of a general linear arrangement and a comparatively nonlinear arrangement (also referred to herein as an “initial arrangement’”), be converted or transitioned to the other one of the general linear arrangement and the comparatively nonlinear arrangement (also referred to herein as a “subsequent arrangement”), and return by itself to the initial arrangement. The linker 106 may be non -biased and may remain in any given arrangement, for example, in response to a force applied thereto or after a force was applied thereto. For example, the linker 106 may be converted or transitioned from the initial arrangement to the subsequent arrangement and remain in the subsequent arrangement.

[0061]

[0061] The mechanical property(ies) of the linker 106, notably the one(s) relating to the flexible, compliant, resilient, and / or deformable aspect(s) thereof, may be the same as or may be different from the one(s) of the first implantable medical device component 102 and / or the second implantable medical device component 104. For example, the linker 106 may be more flexible than the first implantable medical device component 102 and / or the second implantable medical device component 104. The mechanical properties relating to the flexible, compliant, resilient, and / or deformable aspect(s) of the linker 106 may be adjusted or selected to fit any particular need, such as one(s) for using the implantable medical device 100 in vivo.

[0062] FIGS. 2-5, for example, schematically represent possible implantation modalities of the implantable medical device 100 in a subject’s body, such as in the vascular system thereof, according to an aspect of this disclosure.

[0062]

[0063] Referring to FIG. 2, the implantable medical device 100 is represented implanted with the first implantable medical device component 102 provided as an elongated medical device at least partially located in the left subclavian artery and the aortic arch, and with the second implantable medical device component 104 provided as an anchorable and / or operable medical device optionally anchored in the aorta and / or optionally operated therein, according to one or more embodiment s). As illustrated, a flexible linker 106 enables the second implantable medical device component 104 to be appropriately positioned, anchored, and / or operated in the descending aorta. The flexible linker 106 may also enable the second implantable medical device component 104 to be appropriately positioned, anchored, and / or operated in the descending aorta, as illustrated in FIG. 2, but also in the ascending aorta and / or the aortic arch.

[0063]

[0064] Advantageously, the flexible linker 106 enables the implantable medical device 100 to appropriately bend during routing or navigation in a subject’s body, such as through tortuous anatomies, and / or to position appropriately the first and / or second implantable medical device component(s) 102, 104 at a same implantation site or at their respective implantation sites.

[0064]

[0065] The position of the first and / or second implantable medical device component(s) 102, 104 may impact the operation thereof in the subject’s body. For example, if mispositioned, such as when in contact with a lumen wall, the electrical power consumption of any one of the first and second implantable medical device components 102, 104 may increase relative to when they are appropriately positioned away from the lumen wall. A mispositioning may also cause unwanted interaction of the first and second implantable medical device component s) 102, 104 with a lumen wall. For example, when any one of the first and second implantable medical device components 102, 104 is / are blood pump(s), such interaction may cause the blood pump to suction the lumen wall instead of blood, impairing its intended function.

[0065]

[0066] When the first implantable medical device component 102 is provided as an elongated medical device, such as a cannula or a catheter, the flexible linker 106 may be required to be more flexible than the first implantable medical device component 102 for the second implantable medical device component 104 to be positioned appropriately and / or operated appropriately in a subject’s body. This may be the case, as illustrated in FIGS. 2-3, with the first implantable medical device component 102 extending along the left subclavian artery, the second implantable medical device component 104 positioned and optionally anchored in the aorta in a suprarenal position, and the flexible linker 106 accommodating the tortuosity of the aorta (as illustrated) and / or of the left subclavian artery.

[0066]

[0067] Further, since the flexible linker 106 is more flexible than the first implantable medical device component 102, the stiffness of the first implantable medical device component 102 may be adjusted or selected to facilitate navigation of the first implantable medical device component 102 in a subject’s body. For example, an appropriate stiffness of a first implantable medical device component 102 may facilitate the pushing and advancing the first implantable medical device component 102 along a subject’s vascular system.

[0067]

[0068] Absent the flexible linker 106 and with the first implantable medical device component 102 attached to the second implantable medical device component 104, the second implantable medical device component 104 would be mispositioned and / or misaligned relative to the aorta, hindering or preventing the appropriate positioning, anchoring, operation, and / or functioning of the second implantable medical device component 104, as the case may be. Such mispositioning and / or misaligning may happen, for example, when the elongated medical device is not compliant, resilient, flexible, and / or bendable enough to appropriately accommodate a lumen of one or more tortuous body conduits or a lumen of one or more body conduits that have one or more acute angles.

[0068]

[0069] Referring to FIG. 3, the implantable medical device 100 of FIG. 2 is represented but with the second implantable medical device component 104 assembled to three assemblable medical devices 110 and optionally anchored in the aorta, according to one or more embodiment(s). Also, each assemblable medical device 110 may be operated in the aorta. The three assemblable medical devices 110 may also be anchored and / or operated in the in the descending aorta, as illustrated in FIG. 3, but also in the ascending aorta and / or the aortic arch. Similarly to the flexible linker 106, the elongated control structures 114 of the assemblable medical devices 110 are configured to flex and / or bend.

[0070] The appropriate positioning and / or alignment of the second implantable medical device component 104 relative to the aorta advantageously enable the assemblable medical devices 110 to be assembled to the second implantable medical device component 104, unassembled from the second implantable medical device component 104, and operated in the aorta. For example, such positioning and / or alignment enable the downstream-oriented end portion of the assemblable medical devices 110 to be snared downstream from the aorta for the assemblable medical devices 110 to be unassembled from the second implantable medical device component 104, as described herein.

[0069]

[0071] Absent the flexible linker 106, the downstream-oriented end portion of the assemblable medical devices 110 would abut the lumen wall, hindering or preventing appropriate snaring, operation, and / or functioning of the assemblable medical devices 110, as the case may be.

[0070]

[0072] Referring to FIGS. 2-3, the first implantable medical device component 102 may be referred to herein as an “intra-cardiac device”, and the second implantable medical device component 104 may be referred to herein as an “intra-aortic device”.

[0071]

[0073] Referring to FIG. 4, the implantable medical device 100 is represented implanted with the first implantable medical device component 102 optionally anchored in the aorta and optionally including an elongated portion (represented in dashed lines in FIG. 4-5 as optional) configured to run therefrom, with the second implantable medical device component 104 optionally anchored in the aorta and / or optionally operated therein, and finally with the flexible linker 106 positioned through the aortic valve, according to one or more embodiment(s).

[0072]

[0074] As such, the flexible linker 106 advantageously enables the first implantable medical device component 102 and / or the second implantable medical device component 104 to be appropriately positioned and / or anchored in their respective lumens, and / or the implantable medical device 100 to appropriately move (indicated by double-headed arrows in FIGS. 4-5) for accommodating the movement of the left ventricle of a beating heart.

[0073]

[0075] Absent the flexible linker 106 and with the first implantable medical device component 102 attached to the second implantable medical device component 104, the first implantable medical device component 102 and / or the second implantable medical device component 104 would be mispositioned and / or misaligned relative to their respective lumens, hindering or preventing the appropriate operation or functioning of the first implantable medical device component 102 and / or the second implantable medical device component 104, as the case may be. Such mispositioning and / or misaligning may happen, for example, when the first implantable medical device component 102 or the second implantable medical device component 104, but not the flexible linker 106, is positioned through the aortic valve, such that the movement of the left ventricle cannot be appropriately accommodated.

[0074]

[0076] Referring to FIG. 5, the implantable medical device 100 of FIG. 4 is represented but with the second implantable medical device component 104 assembled to three assemblable medical devices 110 and optionally anchored in the left ventricle, according to one or more embodiment(s). Also, each assemblable medical device 110 may be operated in the left ventricle. Similarly to the flexible linker 106, the elongated control structures 114 of the assemblable medical devices 110 are positioned through the aortic valve and are configured to appropriately move for accommodating the movement of the left ventricle.

[0075]

[0077] The appropriate positioning and / or alignment of the first implantable medical device component 102 and / or the second implantable medical device component 104 relative to their respective lumens advantageously enable the assemblable medical devices 110 to be assembled to the second implantable medical device component 104, unassembled from the second implantable medical device component 104, and operated in the left ventricle.

[0076]

[0078] Referring to FIGS. 4-5, the first implantable medical device component 102 may be referred to herein as an “intra-aortic device”, and the second implantable medical device component 104 may be referred to herein as an “intra-cardiac device”.

[0077]

[0079] FIGS. 6-22 illustrate the implantable medical device 100 that includes the first implantable medical device component 102 optionally provided as an elongated medical device, such as a cannula or a catheter 600; the second implantable medical device component 104 optionally provided as various anchorable medical devices; and the flexible linker 106, according to one or more embodiment(s).

[0080] In particular, FIGS. 6-7 illustrate the catheter 600 having first and second end portions 602, 604; an anchorable medical device optionally provided as an anchor 606 having first and second end portions 608, 610; and the flexible linker 106 having a first end portion 612 configured to directly or indirectly couple the second end portion 610 of the anchor 606, and having a second end portion 614 configured to directly or indirectly couple the first end portion 602 of the catheter 600, according to one or more embodiment(s). No assemblable medical device is shown in FIG. 6 for the sake of clarity.

[0078]

[0081] The implantable medical device 100 may include one or more assemblable medical devices 110. For example, as illustrated in FIGS. 7-8, the implantable medical device 100 optionally includes three optional assemblable medical devices 110 provided as three assemblable pumps 700 that are assembled to the anchor 606, according to one or more embodiment(s). As such, the functional unit 112 of the assemblable medical devices 110 has first and second end portions 702, 704 and is provided as a pump unit 706. The elongated control structure 114 of the assemblable medical devices 110 has first and second end portions 708, 710 and is provided as an electrical lead 712. The second end portion 704 of the pump unit 706 is configured to directly or indirectly couple the first end portion 708 of the electrical lead 712. As illustrated in FIG. 8, the second end portion 710 of the electrical lead 712 is provided with an electrical connector 800 configured to electrically connect a controller for operating the pump unit 706, according to one or more embodiment(s).

[0079]

[0082] Each pump unit 706 optionally include an impeller configured to impart movement to a fluid, an electric motor configured to drive the impeller, a magnetic coupling configured to magnetically couple the impeller and the electric motor together for the electric motor to drive the impeller, and a casing configured to enclose the electric motor and from which the electrical lead 712 projects therefrom.

[0080]

[0083] Alternatively, the functional unit 112 may be void of an electric motor and be configured to be mechanically operated by the elongated control structure 114 provided as a driveshaft (not shown).

[0081]

[0084] The functional unit 112 may include a capturable element configured to be intracorporeally captured by a medical tool, such as in the vascular system. The capturable element may also be configured not to intracorporeally engage with or attach to the second implantable medical device component 104 since this may prevent or may interfere with the assembly and unassembly of the assemblable medical device 110. For example, still referring to FIG. 7, each pump unit 706 optionally includes a respective capturable element 714 configured to be intracorporeally captured by a medical tool, such as a snare, in a subject’s body. The capturable element 714 projects generally axially from the pump unit 706, such as from the shroud thereof. The capturable element 714 may also project at an angle from the pump unit 706. The capturable element 714 includes a protrusion 716 and a stem 718 that attaches the protrusion 716 to the pump unit 706. The protrusion 716 may include a magnet or an electromagnet, or be magnetizable for magnetic interaction with a medical tool, such as a snare, used to capture the capturable element 714. The stem 718 may have the same mechanical properties as the flexible linker 106.

[0082]

[0085] The elongated control structure 114 may be manipulable for assembling the functional unit 112 to and unassembling the functional unit 112 from the second implantable medical device component 104. For example, referring back to FIGS. 8-9, the second end portion 710 of each electrical lead 712 can be pulled away from the second end portion 604 of the catheter 600 and can also be pushed toward the second end portion 604 of the catheter 600 for moving a respective pump unit 706 toward and away from the anchor 606, respectively, according to one or more embodiment s). Both pulling and pushing are represented in FIG. 8 by a double-headed arrow, while corresponding movements of the respective pump unit 706 are represented in FIG. 9 by a double-headed arrow. Pulling the electrical lead 712 causes the pump unit 706 to assemble to the anchor 606, while pushing the electrical lead 712 causes the pump unit 706 to unassemble from the anchor 606. As such, the assemblable medical devices 110 are in a slidable relationship with at least one of the catheter 600, the anchor 606, and the flexible linker 106.

[0083]

[0086] It is to be noted for the purpose of this explanation that the electrical lead 712 is shown superposed to the catheter 600 in FIG. 8 instead of being slidably received in a longitudinal guide channel 1100 (shown in FIG. 11) of the catheter 600 as in FIG. 9.

[0084]

[0087] The three functional units 706 may be simultaneously assembled and unassembled by simultaneously pulling and pushing, respectively, the corresponding electrical leads 712. The three functional units 706 may also be consecutively assembled and unassembled by consecutively pulling and pushing, respectively, the corresponding electrical leads 712.

[0085]

[0088] FIG. 9 illustrates an assemblable pump 900 in the assembled configuration with the pump unit 706 thereof assembled to the anchor 606, an assemblable pump 902 in a partially assembled / unassembled configuration with the pump unit 706 thereof partially assembled to or partially unassembled from the anchor 606, and the assemblable pump 904 in the unassembled configuration with the pump unit 706 unassembled from the anchor 606, according to one or more embodiment s). Each of the assemblable pumps 900, 902, 904 is the same than the assemblable pump(s) 700.

[0086]

[0089] Assembled to the anchor 606, the assemblable medical devices 110 may be arranged in various ways. For example, the three pump units 706 may be generally arranged in parallel and generally non-coaxially relative to each other and / or relative to at least one of the anchor 606 (e.g., as illustrated referring back to FIG. 7), the catheter 600, and the flexible linker 106. The three pump units 706 may also be transversally arranged side to side relative to each other (e.g., as illustrated referring back to FIG. 7). Alternatively, when a single assemblable medical device 110 is provided to the implantable medical device 100, its functional unit 112 may or may not be arranged coaxially and / or in parallel relative to at least one the first implantable medical device component 102, the second implantable medical device component 104, and the flexible linker 106.

[0087]

[0090] Unassembled from the anchor 606, the assemblable medical devices 110 may also be arranged in various ways. For example, one or more pump units 706 may be arranged substantially parallel relative to at least one of the first implantable medical device component 102, the second implantable medical device component 104, and the flexible linker 106. The three functional units 706 may also be longitudinally arranged one after the other. Alternatively, or additionally, one or more pump units 706 may be arranged coaxially relative to at least one of the first implantable medical device component 102, the second implantable medical device component 104, and the flexible linker 106.

[0091] Each assemblable pump 700 may be intracorporeally operated in the assembled, partially assembled / unassembled, or unassembled configuration in a subject’s body, such as in the vascular system thereof, by a controller (not shown) extracorporeally disposed outside the subject’s body.

[0088]

[0092] The assemblable medical device 110 may be a blood pump, such as an axial -flow blood pump or a mixed-flow blood pump.

[0089]

[0093] Referring back to FIG. 6, the catheter 600 includes an elongated body 616 that extends between the first and second end portions 602, 604, and defines one or more longitudinal guide channels 1100 (shown in FIG. 11) at least partially extending between the first and second end portions 602, 604, according to one or more embodiment(s). The longitudinal guide channel(s) 1100 is / are configured to slidably receive one or more electrical lead(s) 712 therein for assembling and unassembling corresponding pump unit(s) 706, as described. Alternatively, the first implantable medical device component 102 may be provided with one or more guide holes, such as when the first implantable medical device component 102 does not have an elongated body. Still alternatively, one or more electrical lead(s) 712 may be configured to be positioned outside along the catheter 600.

[0090]

[0094] The catheter 600 may be configured to be atraumatic when used in transcatheter applications, such as when the second end portion 604 of the catheter 600 is introduced through a first subject’s body intracorporeal access, routed in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system, and externalized through a second subject’s body intracorporeal access. For example, as illustrated in FIG. 10, the second end portion 604 of the catheter 600 is optionally of a rounded shape, such as of a tapered and / or profiled shape (in this case, also referred to herein as an “atraumatic end portion or tip”), similar to a dilator tip of an introducer sheath, according to one or more embodiment s). Also, the second end portion 604 of the catheter 600 may optionally include a guidewire (not shown) that projects from the most tapered and / or profiled portion thereof and configured to be intracorporeally routed in a subject’s body, such as in the vascular system.

[0091]

[0095] The second end portion 604 of the catheter 600 may be configured to removably attach (in this case, also referred to herein as a “removable atraumatic end portion or tip”) to the remainder of the catheter 600 (in this case, also referred to herein as the “body of the catheter”), such that one or more longitudinal guide channel(s) 1100 (best shown in FIG. 11) and / or electrical lead(s) 712 slidably received therein is / are protected from the outside environment when the second end portion 604 is attached. The longitudinal guide channel(s) 1100 and / or electrical lead(s) 712, when present, is / are accessible to an operator when the second end portion 604 is removed. For example, as illustrated in FIG. 11, an optional screw thread(s) 1102 is provided to the body of the catheter 600 and is configured to engage a corresponding screw thread(s) (not shown) provided to the removable atraumatic end tip of the catheter 600 of FIG. 10, according to one or more embodiment(s). Alternatively, the second end portion 604 of the catheter 600 may be configured to removably attach the body of the catheter 600 by interference fit or any other suitable attachment means. It is to be noted that the removable second end portion 610 of the catheter 600 is omitted from FIGS. 6, 8, and 11.

[0092]

[0096] FIGS. 12-13 illustrate the anchor 606 that includes a post 1200 extending between the first and second end portions 608, 610 of the anchor 606; six anchoring loops 1202 (also referred to herein as “anchoring elements”) configured to intracorporeally anchor the anchor 606 in a subject’s body; and three assembling loops 1204 (also referred to herein as “assembling loops”) each configured to intracorporeally assemble a respective assemblable pumps 700 in a subject’s body, according to one or more embodiment(s). The second end portion 610 of the anchor 606 is directly or indirectly coupled to the first end portion 612 of the flexible linker 106, resulting in the post 1200 axially projecting from the flexible linker 106. Alternatively, the anchor 606 may include any number of anchoring loops 1202 and assembling loops 1204, and may project from the flexible linker 106 in any direction.

[0093]

[0097] The post 1200 may be inflexible, less flexible than the flexible linker 106, as flexible as the flexible linker 106, or more flexible than the flexible linker 106. When as flexible as the flexible linker 106, the flexible linker 106 may be the post 1200. For example, the post 1200 may be made of nitinol, stainless steel, titanium, any biocompatible alloys, any biocompatible polymers, and the like.

[0094]

[0098] As illustrated in FIGS. 12-13, the six anchoring loops 1202 project generally radially from the post 1200, with three anchoring loops 1202 grouped in a first cluster 1206 positioned proximate the first end portion 608 of the anchor 606, and three other anchoring loops 1202 grouped in a second cluster 1208 positioned at an intermediate portion of the anchor 606, according to one or more embodiment(s). The first and second clusters 1206, 1208 are axially spaced apart from each other along the post 1200. Alternatively, the second cluster 1208 may be positioned proximate the second end portion 610 of the anchor 606. Also, any number of anchoring loops 1202 may be grouped in any number of clusters.

[0095]

[0099] Two or more clusters of anchoring loop(s) 1202 better maintain the post 1200 in a coaxial alignment with the lumen, as opposed to a single cluster of anchoring loops 1202 which is more prone to coaxial misalignment induced by movement of the catheter 600 in the lumen. Coaxial misalignment of the anchor 606 may traumatize or may damage the lumen wall, and / or may cause the functional unit 112 assembled to the anchor 606 to contact or to abut the lumen wall, possibly traumatizing or damaging the lumen wall as well.

[0096]

[0100] The anchoring loops 1202 may be configured to exert pressure to a lumen wall for engaging the lumen wall in a way that the anchor 606 may be moved therealong without traumatizing or damaging the lumen wall. In particular, each anchoring loop 1202 has a respective engagement portion 1210 configured to atraumatically engage an anatomical structure, such as a lumen wall, for anchorage. With the engagement portion 1210 so engaged to a lumen wall, the anchor 606 may be moved in a lumen of a subject’s body conduit, such as the vascular system, by pulling and / or pushing the catheter 600 without traumatizing or damaging the lumen wall. For example, referring to FIG. 13, the engagement portion 1210 is provided as an arched portion 1300 oriented toward the second end portion 610 of the anchor 606, according to one or more embodiment(s). Alternatively, or additionally, the arched portion 1300 may be oriented toward the first end portion 608 of the anchor 606. Still alternatively, the anchoring loops 1202 may be configured to engage the lumen wall in a way that the anchor 606 cannot be moved without traumatizing or damaging the lumen wall.

[0097]

[0101] Referring back to FIG. 9 and as also illustrated in FIGS. 12-13, each anchoring loop 1202 includes an optional respective opening 1302 configured to slidably receive a respective electrical lead 712 and optionally a respective pump unit 706 therethrough, according to one or more embodiment(s).

[0102] As illustrated in FIG. 12, the three assembling loops 1204 project generally radially from the post 1200 and grouped in a single cluster positioned proximate the first end portion 608 of the anchor 606, adjacent the first cluster 1206, according to one or more embodiment(s). Alternatively, the single cluster may be positioned proximate the second end portion 610 of the anchor 606, or the assembling loop(s) 1204 may be grouped in two clusters, generally similarly to the anchoring loop(s) 1202. Also, any number of assembling loops 1204 may be grouped in any number of clusters.

[0098]

[0103] As illustrated in FIGS. 7, 9, 12, and 13, each assembling loop 1204 (also referred to herein as an “assembling element”; best shown in FIG. 9 and 13) forms a respective opening 1302 configured to slidably receive a respective electrical lead 712 therethrough and further configured to slidably receive and / or slidably engage a respective pump unit 706 therein, according to one or more embodiment(s). Alternatively, each assembling loop 1204 may form multiple openings 1302.

[0099]

[0104] In particular, as illustrated in FIG. 9, the electrical lead 712 of the assemblable pump 904 is received through or a respective opening 1302, the pump unit 706 of the assemblable pump 902 is partially received or engaged through a respective opening 1302 (not clearly visible in FIG. 9), and the pump unit 706 of the assemblable pump 900 is received or engaged through a respective opening 1302 (not clearly visible in FIG. 9), according to one or more embodiment(s). Also, as illustrated in FIG. 7, each functional unit 112 of three assemblable pumps 700 are received or engaged in a respective opening 1302, according to one or more embodiment(s). So slidably received and / or slidably engaged, each pump unit 706 may be free-floating or may be immobilized.

[0100]

[0105] Referring to FIG. 11, the catheter 600 optionally includes a securing mechanism 1104 configured to secure an electrical lead 712 (not shown) for retaining a corresponding pump units 706 (not shown) in the opening 1302 of the assembling loops 1204, according to one or more embodiment s). As illustrated, the securing mechanism 1104 is provided to the second end portion 604 of the catheter 600; however, the catheter 600 may be provided anywhere on the first implantable medical device component 102. The assemblable pumps 700 may be retained in the openings 1302 offset relative to each other.

[0101]

[0106] Referring back to FIG. 7, each electrical lead 712 may include, at its first end portion 708, a stop or abutment element 720 configured to abut against or engage with the first end portion 602 of the catheter 600, according to one or more embodiment(s). Additionally, or alternatively, referring to FIG. 8, each electrical lead 712 may include, at its second end portion 710, a stop or abutment element 802 configured to abut against or engage with the second end portion 604 of the catheter 600, according to one or more embodiment(s). Although not necessarily shown as such, each electrical lead 712 may be provided with a stop or abutment element 720 and / or a stop or abutment element 802. Also, the stop or abutment element 720 and / or the stop or abutment element 802 may be located at offset locations relative to each other among multiple electrical leads 712.

[0102]

[0107] The stop or abutment elements 720 allow to predetermine the axial position of the functional units 706 in the openings 1302 of the assembling loops 1204 when abutted or engaged. Stop or abutment elements 720 located at offset locations enable the corresponding functional units 706 to be axially offset relative to each other when assembled to the anchor 606. The stop or abutment elements 802 allow to predetermine the axial position and distance of the functional units 706 relative to the first end portion 602 of the catheter 600. Stop or abutment elements 802 located at offset locations enable the corresponding functional units 706 to be axially positioned and axially distanced offset relative to each other when unassembled from assembled to the anchor 606. As such, the stop or abutment element 802 may prevent the second end portion 710 of the electrical leads 712 from entering inside the longitudinal guide channels 1100 when abutted or engaged. This may be useful when the implantable medical device 100 is routed or navigated in a subject’s body.

[0103]

[0108] As illustrated in FIGS. 12-13, each assembling loop 1204 generally coincide with a respective anchoring loop 1202, such that an opening 1302 of an assembling loop 1204 and an opening 1302 of the anchoring loop 1202 may slidably receive a respective electrical lead 712 (not shown) and a respective pump unit 706 (not shown) therethrough, according to one or more embodiment s). Alternatively, the assembling loops 1204 and anchoring loops 1202 may be offset relative to each on the circumference of the post 1200, such as each assembling loop 1204 may be positioned between two anchoring loops 1202. Also, one or more of the assembling loops 1204 may be axially positioned anywhere along the post 1200, such as closer to the first end portion 608 than the anchoring loops 1202, at an intermediate portion of the post 1200, and / or proximate the second end portion 610 of the post 1200.

[0109] It will be appreciated that, depending on the axial positioning of the assembling loop(s) 1204 relative to anchoring loop(s) 1202 along the post 1200, an electrical lead 712 and optionally a pump unit 706 of an assemblable pump 700 may be received through the opening 1302 of the assembling loop(s) 1204.

[0104] [HO] Both the anchoring loops 1202 and the assembling loops 1204 have an expanded configuration, as illustrated in FIGS. 6, 7, 9, 12, and 13, and a non-expanded configuration, according to one or more embodiment(s).

[0105] [Hl] In the expanded configuration, the anchor 606 is configured to intracorporeally anchor itself and to intracorporeally assemble to the assemblable pump 900, such as in the lumen of a subject’s body conduit. The anchoring loops 1202 and the assembling loops 1204 generally radially project from the post 1200 (also referred to herein as a “deployed configuration”). The anchoring loops 1202 are configured to engage an anatomical structure, such as a lumen wall. The assembling loops 1204 are configured to assemble to corresponding functional units 706 of the assemblable medical devices 110.

[0106]

[0112] In the non-expanded configuration, the anchor 606 is configured for intracorporeal delivery of the implantable medical device 100. The anchoring loops 1202 and the assembling loops 1204 are generally axially positioned along the post 1200 (also referred to herein as an “undeployed configuration”). So positioned, the anchoring loops 1202 and / or the assembling loops 1204 may project toward the first end portion 608 or the second end portion 610 of the anchor 606.

[0107]

[0113] When made of a shape-memory material and overcomeably biased toward the expanded configuration, the anchoring loops 1202 and the assembling loops 1204 may be converted from the non-expanded configuration to the expanded configuration by causing the anchor 606 to exit from a sheath, and be converted from the expanded configuration to the non-expanded configuration by introducing the anchor 606 in a sheath. As such, the anchor 606 is selfexpandable. When made of a non-shape-memory material, the anchoring loops 1202 and the assembling loops 1204 may be converted from the non-expanded configuration to the expanded configuration by inflating a balloon catheter appropriately positioned relative to the anchor 606. The anchoring loops 1202 and the assembling loops 1204 may be converted between the non- expanded configuration and the expanded configuration, and vice versa, in a lumen of a subject’s body conduit, such as in the vascular system.

[0108]

[0114] As illustrated in FIG. 7, the assemblable pumps 700 assembled to the anchor 606 in the expanded configuration are partially surrounded by the first and second clusters 1206, 1208 of the anchoring loops 1202, according to one or more embodiment(s). Such arrangement generally prevents or mitigates any undesired contact of the assemblable pumps 700 with the lumen wall that may possibly traumatize or damage the lumen wall, notably due to the operation of the assemblable pumps 700.

[0109]

[0115] Alternatively to the anchoring loops 1202, the anchoring elements may be provided as anchorable strut(s) (not shown) clustered like the anchoring loop(s) 1202. Each anchorable strut may include a respective engagement portion 1210, which may be provided as a curvature of a most distant end portion of the anchorable strut, opposed to the end portion thereof attached to the post 1200. The anchoring elements may also be provided as a generally rounded geometrical shape at the most distant end portion of the anchorable strut. Each anchorable strut may include an opening, similar to the openings 1302 of the anchoring loops 1202.

[0110]

[0116] The second implantable medical device component 104 may include a capturable element configured to be intracorporeally captured by a medical tool, such as in the vascular system. The capturable element may also be configured not to intracorporeally engage with or attach to the assemblable medical device 110 since this may prevent or may interfere with the assembly and unassembly of the assemblable medical device 110. For example, referring to FIG. 12, the anchor 606 optionally includes a capturable element 1212 configured to be intracorporeally captured by a medical tool, such as a snare, in a subject’s body, according to one or more embodiment(s). The capturable element 1212 projects generally axially from the first end portion 608 of the post 1200. The capturable element 1212 may also project at an angle from the post 1200. The capturable element 1212 includes a bulge 1214 and a stem 1216 that attaches the bulge 1214 to the first end portion 608 of the post 1200. The bulge 1214 may include a magnet or an electromagnet, or be magnetizable for magnetic interaction with a medical tool, such as a snare, used to capture the capturable element 1212. The stem 1216 may be inflexible or flexible like the flexible linker 106. The capturable element 1212 is configured to be captured in a lumen of a subject’s body conduit, such as in the vascular system.

[0111]

[0117] The flexible linker 106 includes any structures capable of appropriately accommodating a given angle of an anatomical structure, such as in a lumen of a subject’s body conduit, in the context of using the implantable medical device 100 in vivo. In such anatomical structure, the implantable medical device 100 not provided with the flexible linker 106 and with the first implantable medical device component 102 directly or indirectly coupled to the second implantable medical device component 104 would be incapable of appropriately accommodating the given angle. The flexible linker 106 may have one or more properties in terms of resilience, compliance, flexibility, and / or bendability that enables the implantable medical device 100 to be appropriately used in a subject’s body, such as in the vascular system. This includes but is not limited to introducing, routing, navigating, delivering, anchoring, assembling, operating, and / or implanting in vivo, as well as unassembling, unanchoring, retrieving, externalizing, and / or explanting in vivo. Such implantable medical device may include, for example, an implantable medical device 100 that is configured for transcatheter and / or percutaneous implantation and / or explantation.

[0112]

[0118] Depending on the implantable medical device 100, the flexible linker 106 may have resilience, compliance, flexibility, and / or bendability properties that is lower than, equal to, or superior to the first implantable medical device component 102 and / or the first implantable medical device component 102.

[0113]

[0119] Still for example, the flexible linker 106 may be provided as an articulated joint, a flexible joint, a pivot point, a hinge, a swivel, and the like, as well as any combination(s) thereof.

[0114]

[0120] The flexible linker 106 may have any shapes. For example, the flexible linker 106 may have a generally linear arrangement or an arced arrangement between the first end portion 612 and the second end portion 614 thereof. The flexible linker 106 may define one or more angles between the first end portion 612 and the second end portion 614 thereof. The flexible linker 106 may include one or more folds between the first end portion 612 and the second end portion 614 thereof. The flexible linker 106 may have any combinations of a linear arrangement, one or more angles, and one or more folds between the first end portion 612 and the second end portion 614 flexible linker 106.

[0115]

[0121] A force of approximately 0.1 Newton applied to the first end portion 612 of the flexible linker 106 may cause the second end portion 614 thereof to move by approximately 5-75 degree.

[0116]

[0122] The length of the flexible linker 106 may be approximately between 1 and 100 centimeters, inclusively.

[0117]

[0123] The flexible linker 106 may be made of nitinol, stainless steel, titanium, any shape-memory material, any biocompatible alloys, any biocompatible polymers, and the like, as well as any combination(s) thereof.

[0118]

[0124] FIGS. 14-15 illustrate the second implantable medical device component 104 optionally provided as another anchorable medical device, such as an anchor 1400, according to one or more embodiment s). In particular, FIG. 14 illustrates the anchor 1400 without any assemblable medical device, and FIG. 15 illustrates the anchor 1400 with three assemblable medical devices assembled to the anchor 1400.

[0119]

[0125] The anchor 1400 includes a post 1402 having the first and second end portions 608, 610, and a helical -like structure 1404 at least partially extending between the first and second end portions 608, 610 of the anchor 1400. The helical-like structure 1404 includes a first helical-like portion 1406 and a second helical -like portion 1408. The first helical-like portion 1406 includes three strands that are directly or indirectly coupled to and extends between the second end portion 610 and an intermediate portion 1410 of the post 1402. The second helical-like portion 1408 also includes three strands that are directly or indirectly coupled to and extends between the intermediate portion 1410 and the first end portion 608 of the post 1402. The strands of the first helical -like portion 1406 are radially arranged closer to the post 1402 as compared to the strands of the second helical-like portion 1408. Alternatively, each of the first helical-like portion 1406 and the second helical-like portion 1408 may include any number of strands so arranged.

[0120]

[0126] The anchor 1400 and the anchor 606 being generally similar to each other, the anchor 1400 will be generally described herein. It will appreciate that the description of the anchor 606 applies to the anchor 1400 with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable.

[0121]

[0127] Still referring to FIGS. 14-15, each strand of the first helical-like portion 1406 forms an assembling loop 1412 (also referred to herein as an “assembling element”) configured to intracorporeally assemble a respective assemblable pump 700 in a subject’s body, according to one or more embodiment(s). In particular, each assembling loop 1412 (also referred to herein as an “assembling element”; only one opening 1414 is labelled in each of FIGS. 14-15 for the sake of clarity) forms a respective opening 1414 configured to slidably receive a respective electrical lead 712 therethrough and further configured to slidably receive and / or slidably engage a respective pump unit 706 therein.

[0122]

[0128] As illustrated in FIG. 15, each pump unit 706 of three assemblable pumps 700 are received or engaged in a respective opening 1414, according to one or more embodiment(s). Slidably received in and / or slidably engaged with the opening 1414, each pump unit 706 may be free- floating or may be immobilized. Alternatively, each strand of the first helical -like portion 1406 may form multiple assembling loops and corresponding openings configured to intracorporeally assemble to one or more respective assemblable pumps 700.

[0123]

[0129] As illustrated in FIGS. 14-15, each strand of the second helical-like portion 1408 forms an anchoring loop 1416 (also referred to herein as an “anchoring element) configured to intracorporeally anchor the anchor 1400 in a subject’s body, according to one or more embodiment s). Each anchoring loop 1416 forms a respective opening 1418 configured to slidably receive a respective electrical lead 712 therethrough and a respective pump unit 706 therein (only one opening 1418 is labelled in each of FIGS. 14-15 for the sake of clarity). In particular, as illustrated in FIG. 15, each pump unit 706 of the three assemblable pumps 700 is slidably received in a respective opening 1418, according to one or more embodiment s). So slidably received, each functional unit 112 is free-floating.

[0124]

[0130] Generally similarly to the anchoring loops 1202, the anchoring loops 1416 may or may not be configured to exert pressure to the lumen wall for engaging the lumen wall in a way that the anchor 1400 may be moved therealong without traumatizing or damaging the lumen wall.

[0131] Alternatively, each strand of the second helical-like portion 1408 may form multiple anchoring loops 1416 and corresponding openings 1418 configured to slidably receive a respective electrical lead 712 therethrough and a respective pump unit 706 therein.

[0125]

[0132] Still alternatively, the strands of the first helical-like portion 1406 may be radially arranged farther from the post 1402 as compared to the strands of the second helical-like portion 1408, such that the first helical -like portion 1406 has the anchoring loops 1416, and the second helical-like portion 1408 has the assembling loops 1412. Also, another second helical-like portion 1408 may be provided to the second end portion 610 of the post 1402, such that the first helical-like portion 1406 is positioned between two second helical-like portions 1408. In the last case, generally similarly to the first and second clusters 1206, 1208 of anchoring loops 1202, two second helicallike portions 1408 better maintain the post 1402 in a coaxial alignment with the lumen, as opposed to a single second helical-like portion 1408 of anchoring loops 1416.

[0126]

[0133] Also generally similarly to the assembling loops 1204 and the anchoring loops 1202, the assembling loops 1412 and the anchoring loops 1416 have an expanded configuration (also referred to herein as a “deployed configuration”), as illustrated in FIGS. 14-15, and a nonexpanded configuration (also referred to herein as an “undeployed configuration”), according to one or more embodiment s). Moreover, as illustrated in FIG. 15, the pump units 706 assembled to the anchor 1400 in the expanded configuration are partially surrounded by or enclosed in the anchoring loops 1416, according to one or more embodiment s). Alternatively, the pump units 706 assembled to the anchor 1600 in the expanded configuration may be entirely surrounded by or enclosed in the anchoring loops 1416.

[0127]

[0134] FIGS. 16-17 illustrate the second implantable medical device component 104 optionally provided as another anchorable medical device, such as an anchor 1600, according to one or more embodiment s). In particular, FIG. 16 illustrates the anchor 1600 without any assemblable medical device, and FIG. 17 illustrates the anchor 1600 with three assemblable medical devices assembled to the anchor 1600.

[0128]

[0135] The anchor 1600 includes a helical-like structure 1602 provided with three strands forming a first helical -like portion 1604 and a second helical-like portion 1606, and extending between the first end portion 608 and the second end portion 610 of the anchor 1600. The portions of the strands that forms the first helical -like portion 1604 are radially arranged farther from a central reference axis 1610 (represented in FIG. 16 by a dashed line) as compared to the strands that forms the second helical-like portion 1606. Alternatively, each of the first helical -like portion 1604 and the second helical -like portion 1606 may include any number of strands so arranged.

[0129]

[0136] The anchor 1600 as well as the anchors 606 and 1400 being generally similar to each other, the anchor 1600 will be generally described herein. It will appreciate that the descriptions of the anchors 606 and 1400 apply to the anchor 1600 with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable.

[0130]

[0137] Still referring to FIGS. 16-17 each strand of the first helical-like portion 1604 forms an anchoring loop 1612 (also referred to herein as an “anchoring element”) configured to intracorporeally anchor the anchor 1600 in a subject’s body, according to one or more embodiment(s). Each anchoring loop 1612 forms a respective opening 1614 (only one opening 1614 is labelled in each of FIGS. 16-17 for the sake of clarity) configured to slidably receive a respective electrical lead 712 therethrough and optionally a pump unit 706 of the three assemblable pumps 700 is slidably received in a respective opening 1614, according to one or more embodiment s). So slidably received, each functional unit 112 may be free-floating.

[0131]

[0138] Generally similarly to the anchoring loops 1202, the anchoring loops 1612 may or may not be configured to exert pressure to the lumen wall for engaging the lumen wall in a way that the anchor 1600 may be moved therealong without traumatizing or damaging the lumen wall.

[0132]

[0139] Alternatively, each strand of the first helical -like portion 1604 may form multiple anchoring loops 1612 and corresponding openings 1614 configured to slidably receive a respective electrical lead 712 therethrough and a respective pump unit 706 therein.

[0133]

[0140] As illustrated in FIGS. 16-18, each strand of the second helical-like portion 1606 forms an assembling loop 1616 (also referred to herein as an “assembling element”) configured to intracorporeally assemble a respective assemblable pump 700 in a subject’s body, according to one or more embodiment s). In particular, each assembling loop 1616 (also referred to herein as an “assembling element”; only one opening 1618 is labelled in each of FIGS. 16-17 for the sake of clarity) forms a respective opening 1618 configured to slidably receive a respective electrical lead 712 therethrough and further configured to slidably receive and / or slidably engage a respective pump unit 706 therein.

[0134]

[0141] As illustrated in FIG. 17, each pump unit 706 of three assemblable pumps 700 are received or engaged in a respective opening 1618, according to one or more embodiment s). Slidably received in and / or slidably engaged with the opening 1618, each pump unit 706 may be free- floating or may be immobilized. Alternatively, each strand of the second helical-like portion 1606 may form multiple assembling loops 1616 and corresponding openings 1618 configured to intracorporeally assemble to one or more respective assemblable pumps 700.

[0135]

[0142] Still alternatively, the strands of the second helical -like portion 1606 may be radially arranged farther from the central reference axis 1610 as compared to the strands of the first helicallike portion 1604, such that the second helical-like portion 1606 has the assembling loops 1616, and the first helical-like portion 1604 has the anchoring loops 1612. Also, as illustrated in FIG. 18, another first helical-like portion 1604 may be provided to the first end portion 608 of the anchor 1600, such that the second helical-like portion 1606 is positioned between two first helical -like portions 1604. In the last case, generally similarly to the first and second clusters 1206, 1208 of the anchoring loops 1202, two first helical-like portions 1604 better maintain the anchor 1600 in a coaxial alignment with the lumen, as opposed to a single first helical-like portion 1406 of anchoring loops 1612. It is to be noted that the catheter 600 and capturable element 714 are omitted from FIG. 18.

[0136]

[0143] Also, generally similarly to the assembling loops 1204 and the anchoring loops 1202, the assembling loops 1616 and the anchoring loops 1612 have an expanded configuration (also referred to herein as a “deployed configuration”), as illustrated in FIGS. 16-17, and a nonexpanded configuration (also referred to herein as an “undeployed configuration”), according to one or more embodiment(s). Moreover, as illustrated in FIG. 17, the assemblable pumps 700 assembled to the anchor 1600 in the expanded configuration are partially surrounded by or enclosed in the anchoring loops 1612, according to one or more embodiment(s). Alternatively, the assemblable pumps 700 assembled to the anchor 606 in the expanded configuration may be entirely surrounded by or enclosed in the anchoring loops 1202.

[0144] FIGS. 19-22 illustrate the second implantable medical device component 104 optionally provided as another anchorable medical device, such as an anchor 1900, according to one or more embodiment s). In particular, FIGS. 19-20 illustrate the anchor 1900 provided with a stent-like structure 1902 and an optional post 1904 positioned within the stent-like structure 1902. FIGS. 21- 22 illustrate the anchor 1900 with the stent-like structure 1902 alone, without any post. FIGS. 19 and 21 illustrate the anchor 1900 unassembled from three assemblable pumps 900. FIGS. 20 and 22 illustrate the anchor 1900 assembled to three assemblable pumps 900. The stent-like structure 1902 has a tubular wall having an outer wall surface configured to engage an anatomical structure, such as a lumen wall. The tubular wall of the stent-like structure 1902 is illustrated as transparent in FIGS. 19-22 as a way to see through it.

[0137]

[0145] The anchor 1900 and the anchor 606 being generally similar to each other, the anchor 1900 will be generally described herein. It will appreciate that the description of the anchor 606 applies to the anchor 1900 with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable.

[0138]

[0146] As illustrated in FIGS. 19-20, the post 1904 extends through a longitudinal bore (also referred to herein as an “opening”) of the stent-like structure 1902 between the first end portion 608 and the second end portion 610 of the anchor 1900, is attached at the first end portion 608 by three arms 1906 to the stent-like structure 1902, and is further attached at the second end portion 610 to the flexible linker 106, according to one or more embodiment s). Alternatively, any number of arms may be provided anywhere along the post 1904 and may attach anywhere to the stent-like structure 1902. The anchor 1900 includes three assembling loops 1908 (also referred to herein as an “assembling element”) provided to the post 1904. Each assembling loop 1908 may be directly or indirectly attached to the post 1904.

[0139]

[0147] As illustrated in FIGS. 21-22, the anchor 1900 has no post, and the flexible linker 106 is attached to the second end portion 610 of the stent-like structure 1902 by any number of arms 1906 (not shown), according to one or more embodiment s). The anchor 1900 includes three assembling loops 1908 (also referred to herein as an “assembling element”) provided to an inner wall surface of the tubular wall. Each assembling loop 1908 may be directly or indirectly coupled to the tubular wall.

[0148] Referring to FIGS. 19-22, the tubular wall of the stent-like structure 1902 may or may not be configured to exert pressure to a lumen wall for the outer wall surface (also referred to herein as an “anchoring element” having an “engagement portion”) of the tubular wall to engage the lumen wall in a way that the anchor 1900 may be moved therealong without traumatizing or damaging the lumen wall, as described herein.

[0140]

[0149] Further, as illustrated, the longitudinal bore of the stent-like structure 1902 is configured to slidably receive the electrical leads 712 of the assemblable pumps 900 therethrough, with each electrical lead 712 passing through a respective passage defined by two adjacent arms 1906, as the case may be. The three assembling loops 1908 are configured to intracorporeally assemble and unassemble a respective pump unit 706 in a subject’s body, as described herein. The assembling and unassembling of the pump units 706 are as described herein.

[0141]

[0150] Any number of assemblable medical devices 110, such as the assemblable pumps 900, may be provided to the implantable medical device 100. Depending on the arrangement of the second implantable medical device component 104, such as the anchors 606, 1400, 1600, 1900, any number of assembling elements, such as the assembling loops 1204, 1412, 1616, 1908, may be provided to the second implantable medical device component 104 for assembling any number of assemblable medical devices 110. Any number of assembling loops 1908 may be provided to each arm 1906 of the anchor 1900. In particular, a single assemblable medical device 110 and one or more assembling element may be configured to assemble together and unassemble for each other. A single assembling element and one or more assemblable medical device 110 may be configured to assemble together and unassemble for each other.

[0142]

[0151] The stent-like structure 1902, the arms 1906, and the assembling loops 1908 have an expanded configuration, as illustrated in FIGS. 19-22, and a non-expanded configuration, according to one or more embodiment(s).

[0143]

[0152] In the expanded configuration, the anchor 1900 is configured to intracorporeally anchor itself and to intracorporeally assemble to the pump units 706, such as in the lumen of a subject’s body conduit. The stent-like structure 1902 has its tubular wall deployed and is configured to engage a lumen wall. The arms 1906 and the assembling loops 1908 generally radially project from the post 1904 and / or from the inner wall surface of the tubular wall, as the case may be (also referred to herein as a “deployed configuration”). The assembling loops 1908 are configured to assemble to corresponding functional units 706 of the assemblable medical devices 110.

[0144]

[0153] In the non-expanded configuration, the anchor 1900 is configured for intracorporeal delivery of the implantable medical device 100. For example, one or more assemblable medical devices may be intracorporeally sheathable in a subject’s body, for example for retrieving or explanting the implantable medical device or an assemblable medical device. The stent-like structure 1902 is generally collapsed and may have its tubular wall positioned closer to the post 1904 compared to when the tubular wall is deployed. The arms 1906 and the assembling loops 1908 are generally positioned along the inner surface of the tubular wall and the post 1904, as it may be the case (also referred to herein as an “undeployed configuration”). So positioned, the arms 1906 and / or the assembling loops 1908 may project toward the first end portion 608 of the anchor 606 outside the longitudinal bore of the tubular wall, or toward the second end portion 610 of the anchor 606 inside the longitudinal bore of the tubular wall.

[0145]

[0154] When made of a shape-memory material and overcomeably biased toward the expanded configuration, the anchor 1900 may be converted from the expanded configuration to the nonexpanded configuration by introducing the anchor 1900 in a sheath, for example. In this case, the first end portion 608 of the anchor 1900 may have a chamfer or be rounded to facilitate the introduction. As such, the anchor 1900 is self-expandable. When made of a non-shape-memory material, the anchoring loops 1908 may be converted from the non-expanded configuration to the expanded configuration by inflating a balloon catheter appropriately positioned in the longitudinal bore of the tubular wall, for example. The anchor 1900 may be converted between the nonexpanded configuration and the expanded configuration, and vice versa, in a lumen of a subject’s body conduit, such as in the vascular system.

[0146]

[0155] As illustrated in FIGS. 20 and 22, the assemblable pumps 700 assembled to the anchor 1900 in the expanded configuration are surrounded by the stent-like structure 1902, according to one or more embodiment(s). Such arrangement generally prevents or mitigates any undesired contact of the assemblable pumps 700 with the lumen wall, as described herein. Alternatively, the assemblable pumps 700 assembled to the anchor 1900 in the expanded configuration may be partially surrounded by the stent-like structure 1902, such that one or more assemblable pumps 700 project outside the longitudinal bore of the tubular wall at the first end portion 608 and / or at the second end portion 610 of the anchor 1900. Depending on the assemblable pumps 700, this last arrangement may also generally prevent or mitigates any undesired contact of the assemblable pumps 700 with the lumen wall.

[0147]

[0156] As illustrated in FIGS. 20 and 22, the anchor 1900 optionally includes a capturable element 2000 attached to the first end portion 608 of the anchor 1900 by three arms 1906, and configured to be intracorporeally captured by a medical tool, as described herein, according to one or more embodiment s). The capturable element 2000 is omitted from FIGS. 21 and 22 for the sake of clarity.

[0148]

[0157] In complement to the schematical representations of FIGS. 2-5, FIGS. 23-24 present the implantable medical device 100 provided with the catheter 600 and the anchor 606, and implanted in a portion of a mock anatomical vascular system, according to an aspect of this disclosure. In particular, FIGS. 23 and 24 present the anchor 606 without any assemblable pump and with the pump units 706 of two assemblable pumps 700 assembled thereto, respectively, according to one or more embodiment(s). Only two instead of three assemblable pumps 700 are represented in FIG. 24 for the sake of clarity.

[0149]

[0158] The implantable medical device 100 is implanted such that the anchor 606 and the two assemblable pumps 700 are positioned inside a descending aorta, while the catheter 600 is routed from the anchor 606 up to a left subclavian artery and ultimately outside the mock anatomical vascular system. As illustrated in FIGS. 23-24, the flexible linker 106 and the two electrical leads 712 of the two assemblable pumps 700 are flexed or bended to appropriately accommodate an angle defined by the descending aorta. Absent the flexible linker 106 and with the anchor 606 attached to the catheter 600, the catheter 600 could not pass through the angle for the anchor 606 to be appropriately positioned and / or anchored inside the descending aorta. The two pump units 706 are also positioned for appropriate operation inside the descending aorta. It is to be noted that the left subclavian artery of the mock anatomical vascular system is only visible in FIG. 23.

[0150]

[0159] The implantable medical device 100 may be intracorporeally implanted in a subject’s body in a manner similar to its implantation in the mock anatomical vascular system of FIGS. 23-24, according to one or more embodiment s). In this case, the second end portion 604 of the catheter 600 is externalized outside the subject’s body through a subject’s body intracorporeal access, such as an axillary or subclavian intracorporeal access. So externalized, each electrical lead 712, which are slidably received through the catheter 600, may be manipulated at the second end portion 604 of the catheter 600 for assembling and unassembling a respective pump unit 706 to the anchor 606 inside the aorta. Further, the second end portion 710 of each electrical lead 712 may be connected to a controller (not shown) for operating a respective pump unit 706 inside the aorta, for example to provide a hemodynamic effect.

[0151]

[0160] The implantable medical device 100 may be a transcatheterly implantable medical device.

[0152]

[0161] The implantable medical device 100 may include any one of the medical devices listed under LIST 1 hereinafter that is provided with the flexible linker 106 between two or more of its components.

[0153]

[0162] The implantable medical device 100 may also include any one of the medical devices listed under LIST 1 hereinafter which are provided as the first implantable medical device component 102 and / or as the second implantable medical device component 104.

[0154]

[0163] The implantable medical device 100 may include one or more assemblable medical devices, and the assemblable medical device(s) may include any one of the medical devices listed under LIST 1 hereinafter.

[0155]

[0164] LIST 1 : a blood pump; a percutaneous ventricular assist device; a stent; a stent-graft; a catheter or cannula; an intra-aortic balloon, including an intra-aortic balloon counter pulsation; an endovascular or stent graft; a vascular closure device; an embolic protection device; an occluder, including a left atrial appendage occluder; a drug-eluting device; a pacemaker; an implantable cardioverter defibrillator; an insertable or implantable monitoring device, such as an insertable or implantable hemodynamic monitoring device; a valve, such as a heart valve, and a related delivery system; a valvuloplasty device; an annuloplasty device; an annuloplasty ring; and / or a prosthetic valve chords.

[0156]

[0165] According to another aspect, this disclosure also relates to an anchor that is similar to any one of the anchors 606, 1400, 1600, 1900 described herein, provided or not with the flexible linker 106. In this case, such anchor may also be referred to herein as an “anchorable and assemblable medical device, structure, or unit” or as an “assemblable medical device anchor”. Such anchor may or may not be provided with any number of assemblable medical devices, according to one or more embodiment(s).

[0157]

[0166] According to another aspect, this disclosure also relates to an implantable medical device that is similar to the implantable medical device 100 described herein, but provided without the flexible linker 106 and with the first implantable medical device component 102 directly or indirectly coupled to the second implantable medical device component 104. Such implantable medical device may or may not be provided with any number of assemblable medical devices, according to one or more embodiment(s).

[0158] Methods of Implanting an Implantable Medical Device Having a Flexible Linker

[0159]

[0167] According to another aspect, as illustrated in FIG. 25, this disclosure also relates to a method 2500 of implanting a medical device (e.g., the implantable medical device 100) in a subject’s body (e.g., in the cardiovascular system thereof). The medical device includes a first implantable medical device component (e.g., the first implantable medical device component 102), a second implantable medical device component (e.g., the second implantable medical device component 104), and a linker (e.g., the linker 106) that links the first implantable medical device component and the second implantable medical device component together. The method 2500 includes implanting 2502 the medical device in the subject’s body to cause the linker to change the implantable medical device from a first arrangement to a second arrangement.

[0160]

[0168] Referring back to FIGS. 2-3, for example, implanting 2502, may include implanting the implantable medical device in a subject vascular system, such that the first implantable medical device component is at least partially located in the left subclavian artery and / or the aortic arch, while the second implantable medical device component is at least partially located in in the descending aorta, as illustrated in FIGS. 2-3, but also in the ascending aorta and / or the aortic arch., according to one or more embodiment(s).

[0161]

[0169] Referring back to FIGS. 4-5, for example, implanting 2502 may include implanting the implantable medical device in a subject vascular system, such that the linker is received through the orifice of the aortic valve, while the first implantable medical device component is located in the ascending aorta, as illustrated in FIGS. 4-5, but also in the aortic arch and / or the descending aorta, and the second implantable medical device component is located in the left ventricle, according to one or more embodiment(s).

[0162]

[0170] Implanting 2502 may include implanting the implantable medical device in a subject vascular system according to the following modalities:

[0163]

[0171] (i) the linker is at least partially located in the left common carotid artery and / or the aorta, while the first implantable medical device component is at least partially located in the left common carotid artery, and the second implantable medical device component is at least partially located in the aorta;

[0164]

[0172] (ii) the linker is at least partially located in the brachiocephalic trunk and / or the aorta, while the first implantable medical device component is at least partially located in the brachiocephalic trunk, and the second implantable medical device component is at least partially located in the aorta;

[0165]

[0173] (iii) the linker is at least partially located in a radial artery and / or the aorta, while the first implantable medical device component is at least partially located in the radial artery, and the second implantable medical device component is at least partially located in the aorta;

[0166]

[0174] (iv) the linker is at least partially located in the aorta and / or one of the renal arteries, while the first implantable medical device component is at least partially located in the aorta, and the second implantable medical device component is at least partially located in a corresponding one of the renal arteries;

[0167]

[0175] (v) the linker is at least partially located in the inferior vena cava and / or one of the renal veins, while the first implantable medical device component is at least partially located in the inferior vena cava, and the second implantable medical device component is at least partially located in a corresponding one of the renal veins;

[0168]

[0176] (vi) the linker is at least partially located in the aorta and / or one of the femoral arteries, while the first implantable medical device component is at least partially located in the aorta, and the second implantable medical device component is at least partially located in the femoral artery;

[0177] (vii) the linker is at least partially located in the inferior vena cava and / or one of the femoral veins, while the first implantable medical device component is at least partially located in the inferior vena cava, and the second implantable medical device component is at least partially located in the femoral veins;

[0169]

[0178] (viii) the linker is passed from the inferior vena cava to the aorta, while the first implantable medical device component is at least partially located in the inferior vena cava, and the second implantable medical device component is at least partially located in the aorta;

[0170]

[0179] (ix) the linker is at least partially located in one of the jugular veins, the left or right brachiocephalic vein, the superior vena cava, and / or the right ventricle, while the first implantable medical device component is at least partially located in a corresponding one of the jugular veins, and the second implantable medical device component is at least partially located the right ventricle;

[0171]

[0180] (x) the linker is at least partially located in one of the jugular veins, the left or right brachiocephalic vein, the superior vena cava, the right ventricle, and / or through the orifice(s) of at least one of the tricuspid valve and the pulmonary valve, while the first implantable medical device component is at least partially located in a corresponding one of the jugular veins, and the second implantable medical device component is at least partially located in the left or right pulmonary artery;

[0172]

[0181] (xi) the linker is at least partially located in the left or right brachiocephalic vein, the superior vena cava, and / or the right atrium, while the first implantable medical device component is at least partially located in a corresponding one of the left and right brachiocephalic veins, and the second implantable medical device component is at least partially located in the right atrium;

[0173]

[0182] (xii) the linker is at least partially located in the left or right brachiocephalic vein, the superior vena cava, the right atrium, through the orifice of the tricuspid valve, and / or the right ventricle, while the first implantable medical device component is at least partially located in a corresponding one of the left and right brachiocephalic veins, and the second implantable medical device component is at least partially located in the right ventricle;

[0183] (xiii) the linker is received through the orifice of the mitral / bicuspid valve, while the first implantable medical device component is at least partially located in the left ventricle, and the second implantable medical device component is at least partially located in the left atrium;

[0174]

[0184] (xiv) the linker is received through the orifice of the aortic valve and the mitral / bicuspid valve, while the first implantable medical device component is at least partially located in the aorta, and the second implantable medical device component is at least partially located in the left atrium;

[0175]

[0185] (xv) the linker is received through the orifices of the aortic valve, the mitral / bicuspid valve, and the atrial septum, while the first implantable medical device component is at least partially located in the aorta, and the second implantable medical device component is at least partially located in the inferior or superior vena cava; and

[0176]

[0186] (xvi) the linker is disposed through the atrial septum, while the first implantable medical device component is at least partially located in the left atrium, and the second implantable medical device component is at least partially located in the right atrium.

[0177]

[0187] Implanting 2502 may cause the linker to momentarily transition from the first arrangement to the second arrangement, and vice-versa. For example, this may be the case when the implantable medical device is introduced, routed, and / or navigated in a lumen of a subject’s body conduit, causing the linker to momentarily flex, bend, articulate, pivot, hinge, or swivel for the implantable medical device to accommodate a tortuous portion of the lumen along the way.

[0178]

[0188] Implanting 2502 may also cause the linker to remain transitioned from the first arrangement to the second arrangement, and vice-versa, for the duration of its use. For example, this may be the case when the implantable medical device is delivered, anchored, assembled, operated, and / or implanted in a lumen of a subject’s body conduit, causing the linker to remain so transitioned until explantation or repositioning.

[0179]

[0189] Implanting 2502 may include transcatheterly implanting the implantable medical device in the vascular system of the subject’s body. In particular, an optional guidewire of the implantable medical device is introduced through a first subj ect’s body access in the vascular system and routed therein up to an intraluminal location. The optional guidewire is captured or snared at the intraluminal location by a snare having been introduced through a second subject’s body access in the vascular system and having been routed therein up to the optional guidewire.

[0180]

[0190] Then, the implantable medical device is implanted by navigating the implantable medical device up to an intraluminal implantation site. In particular, the implantable medical device is introduced, such as by pushing it, through the first subject’s body access in the vascular system, and / or by pulling the snare from the second subject’s body access, to navigate the implantable medical device adjacent or up to the intraluminal implantation site. In doing so, a portion of the implantable medical device may or may not be at least partially externalized through the second subject’s body access. The snare may be detached from the implantable medical device inside the subject’s body, when the implantable medical device remains in the subject’s body, or outside the subject’s body, when the implantable medical device is externalized.

[0181]

[0191] For example, the guidewire may be provided to the first implantable medical device component 102 of the implantable medical device (e.g., to the second end portion 604 of the catheter 600). An atraumatic end portion (e.g., the second end portion 604 of the catheter 600) of the first implantable medical device component 102 may be introduced through the first subject’s body access. The first implantable medical device component 102 may be introduced through the first subject’s body access before the second implantable medical device component 104 is introduced through the first subject’s body access.

[0182]

[0192] Alternatively, in absence of the optional guidewire, the implantable medical device is introduced, such as by pushing it, through the first subject’s body access in the vascular system and navigated therein up to the intraluminal implantation site. As described herein, doing so, a portion of the implantable medical device may or may not be at least partially externalized through the second subject’s body access, and the snare may be detached from the implantable medical device inside or outside the subject’s body.

[0183]

[0193] For example, the first implantable medical device component 102 or the second implantable medical device component 104 of the implantable medical device, which may be provided with an atraumatic portion, may be introduced through the first subject’s body access in the vascular system. The first implantable medical device component 102 may be introduced through the first subject’s body access before the second implantable medical device component 104 is introduced through the first subject’s body access.

[0184]

[0194] Either provided with an optional guidewire or not, the implantable medical device may alternatively be at least partially enclosed in a delivery sheath (also referred to herein as “sheathed”) for implantation. In particular, the delivery sheath is introduced, such as by pushing it, through the first subject’s body access in the vascular system, and / or by pulling the snare from the second subject’s body access, to navigate the delivery sheath adjacent or up to the intraluminal implantation site. Then, the implantable medical device is caused to exit the delivery sheath (also referred to herein as “unsheating”).

[0185]

[0195] The method 2500 may optionally include: anchoring 2504 the implantable medical device in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system. The first implantable medical device component and / or the second implantable medical device component, when provided as an anchor made of a shape-memory material (e.g., the anchors 606, 1400, 1600, 1900), may be anchored while being unsheathed from the delivery sheath, as described herein. The first implantable medical device component and / or the second implantable medical device component, when provided as an anchor made of a non-shape-memory material (e.g., the anchors 606, 1400, 1600, 1900), may be anchored using a balloon catheter, as also described herein.

[0186]

[0196] For example, one of the first implantable medical device component and / or the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900) may be anchored, while the other one of the first implantable medical device component (e.g., the catheter 600) and / or the second implantable medical device component may or may not be.

[0187]

[0197] The method 2500 may optionally include: operating 2506 the implantable medical device in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system. The first implantable medical device component and / or the second implantable medical device component may be electrically or mechanically connected to a controller for electrically or mechanically operating the first implantable medical device component and / or the second implantable medical device component. One of the first implantable medical device component and / or the second implantable medical device component may be operated through the other one of the first implantable medical device component and / or the second implantable medical device component and / or the linker. The connection between the first implantable medical device component and / or the second implantable medical device component may be performed inside or outside the subject’s body. Alternatively, the first implantable medical device component and / or the second implantable medical device component may be electrically or mechanically operated wirelessly.

[0188]

[0198] For example, one of the first implantable medical device component (e.g., the catheter 600) and / or the second implantable medical device component may be electrically connected to a controller outside the subject’s body to electrically operate the other one of the first implantable medical device component and / or the second implantable medical device component (e.g., one or more pumps) inside the subject’s body.

[0189]

[0199] The method 2500 may optionally include: assembling 2508 the implantable medical device in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system. The implantable medical device may optionally include an assemblable medical device (such as the assemblable medical device 110) configured to assemble to the first implantable medical device component (e.g., the first implantable medical device component 102), the second implantable medical device component (e.g., second implantable medical device component 104), and / or the linker of the implantable medical device. Multiple assemblable medical devices may be so assembled to the implantable medical device.

[0190]

[0200] For example, the assemblable medical device, the first implantable medical device component, and / or the second implantable medical device component may be extracorporeally manipulated from outside the subject’s body for intracorporeally assembling the assemblable medical device inside the subject’s body. In particular, the assemblable medical device may be pulled relative to the first implantable medical device component and the second implantable medical device component, and / or the first implantable medical device component and the second implantable medical device component may be pushed relative to the assemblable medical device for assembling. A portion of the assemblable medical device (e.g., the elongated control structure 114 and the electrical lead 712) may be pulled from outside the subject’s body, such as through the second subject’s body access, for assembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900) together inside the subject’s body. Additionally, or alternatively, the second implantable medical device component (e.g., the catheter 600) may be pushed from outside the subject’s body, such as through the first subject’s body access, for assembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component 104 (e.g., the anchors 606, 1400, 1600, 1900) together inside the subject’s body.

[0191]

[0201] Still for example, the assemblable medical device, the first implantable medical device component, the second implantable medical device component, and / or the linker may be mechanically or electrically actuated for assembly. In particular, the elongated control element (e.g. the electrical lead 712) of the assemblable medical device may be extracorporeally or intracorporeally actuated for intracorporeally assembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900). The actuation may be commanded extracorporeally from outside or intracorporeally from inside the subject’s body.

[0192]

[0202] In an implementation, for example, the method 2500 includes: transcatheterly implanting 2502 the implantable medical device in the vascular system of the subject, such that (i) the first implantable medical device component at least partially extends from an intraluminal implantation site up to an extracorporeal location outside the subject’s body, (ii) the second implantable medical device component is located at the intraluminal implantation site, (iii) the linker is directly or indirectly coupled to and extends between the first implantable medical device component and the second implantable medical device component, and (iv) the optional assemblable medical device at least partially extends from the intraluminal implantation site up to an extracorporeal location outside the subject’s body. Anchoring 2504 the implantable medical device, such as the second implantable medical device component thereof, at the intraluminal implantation site. Assembling 2508 the implantable medical device, such as the second implantable medical device component thereof, and the assemblable medical device, such as a functional unit thereof, together at the intraluminal implantation site by manipulating the implantable medical device and / or the assemblable medical device from outside the subject’s body. The implantable medical device and / or the assemblable medical device may be manipulated by pulling and / or pushing it or them for assembling. Operating 2506 the assemblable medical device, such as the functional unit thereof, at the intraluminal implantation site. The assemblable medical device may be operated from outside the subject’s body by connecting it to a controller, or wirelessly.

[0193]

[0203] In this last implementation, as well as any other implementations herein, implanting 2502, anchoring 2504, operating 2506, and assembling 2508 may be performed in any order, depending on the medical procedure.

[0194] Methods of Explanting an Implantable Medical Device Having a Flexible Linker

[0195]

[0204] According to another aspect, as illustrated in FIG. 26, this disclosure also relates to a method 2600 of explanting a medical device (e.g., the implantable medical device 100) from a subject’s body (e.g., in the cardiovascular system thereof). The medical device includes a first implantable medical device component (e.g., the first implantable medical device component 102), a second implantable medical device component (e.g., the second implantable medical device component 104), and a linker (e.g., the linker 106) that links the first implantable medical device component and the second implantable medical device component together. The method 2600 includes explanting 2602 the medical device from the subject’s body to cause the linker to change the implantable medical device from a first arrangement to a second arrangement.

[0196]

[0205] The first and second arrangements, as well as the change, conversion and transitioning therebetween are generally similar between the methods 2600 and 2500; therefore, it will appreciate that the description of the method 2500 applies to the method 2600 with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable. Also, as described herein for the method 2500, the implanted medical device of the method 2600 may be implanted as represented in FIGS. 2-5, according to one or more embodiment s).

[0197]

[0206] Explanting 2602 may include explanting the medical device implanted in a subj ect vascular system according to the modalities (i) to (xvi) described for the method 2500.

[0198]

[0207] Explanting 2602 may cause the linker to momentarily transition from the first arrangement to the second arrangement, and vice-versa. For example, this may be the case when the implantable medical device is routed in, navigated in, and / or externalized from a lumen of a subject’s body conduit, causing the linker to momentarily flex, bend, articulate, pivot, hinge, or swivel for the implantable medical device to accommodate a tortuous portion of the lumen along the way.

[0208] Explanting 2602 may also cause the linker to remain transitioned from the first arrangement to the second arrangement, and vice-versa, for the duration of its use. For example, this may be the case when the implantable medical device is unassembled in, unanchored in, retrieved from, and / or explanted from a lumen of a subject’s body conduit, causing the linker to remain so transitioned until explantation or repositioning.

[0199]

[0209] Explanting 2602 may include transcatheterly explanting the implanted medical device from the vascular system of the subject’s body. In particular, a medical tool, such as a snare, is introduced through the first subject’s body access in the vascular system and routed therein up to an implanted medical device. The medical tool is then manipulated to capture (also referred to herein as “to snare”) an optional capturable element (e.g., the capturable element 1214) of the implanted medical device, and is pulled through the first subject’s body access to retrieve or explant the implanted medical device therethrough from the subject’s body. A portion of the implanted medical device (e.g., the catheter 600) that is at least partially externalized through the second subject’s body access may Additionally, or alternatively be pushed therethrough for retrieval or explantation.

[0200]

[0210] The implanted medical device may also be retrieved or explanted using an optional retrieval sheath. In particular, the retrieval sheath is railed over the medical tool up to the implanted medical device. Then, the implanted medical device is caused to enter the retrieval sheath (also referred to herein as “sheating”) by pulling the medical tool from the first subject’s body access and the retrieval sheath, and / or by pushing the retrieval sheath against the implanted medical device.

[0201] [2H] The method 2600 may optionally include: unanchoring 2604 the implanted medical device from a subject’s body, such as from a lumen of a subject’s body conduit like the vascular system. The first implantable medical device component and / or the second implantable medical device component, when provided as an anchor made of a shape-memory or non-shape-memory material (e.g., the anchors 606, 1400, 1600, 1900), may be unanchored while being sheathed by the retrieval sheath, as described herein.

[0202]

[0212] For example, one of the first implantable medical device component and / or the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900) may be unanchored, while the other one of the first implantable medical device component (e.g., the catheter 600) and / or the second implantable medical device component may or may not be.

[0203]

[0213] The method 2600 may optionally include: stopping 2606 the operation of the implanted medical device being electrically or mechanically operated in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system. The operation of the implanted medical device may be stopped via a controller and / or by disconnecting the implanted medical device from the controller. The disconnection may be performed outside or inside the subject’s body. When connected to the controller, the implanted medical device may be required to be disconnected therefrom before explanting 2602, unanchoring 2604, and / or unassembling 2608 (described hereinafter).

[0204]

[0214] The connection(s) of the implanted medical device of the method 2600 being generally similar to the connection(s) of the implantable medical device of the method 2500, it will appreciate that the description of the method 2500 applies to the method 2600 with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable.

[0205]

[0215] The method 2600 may optionally include: unassembling 2608 the implanted medical device in a subject’s body, such as in a lumen of a subject’s body conduit like the vascular system. The implanted medical device may optionally include an assemblable medical device (such as the assemblable medical device 110) assembled to the first implantable medical device component (e.g., the first implantable medical device component 102), the second implantable medical device component (e.g., second implantable medical device component 104), and / or the linker of the implanted medical device. Multiple assemblable medical devices may be so unassembled from the implanted medical device.

[0206]

[0216] For example, the assemblable medical device, the first implantable medical device component, and / or the second implantable medical device component may be extracorporeally manipulated from outside the subject’s body for intracorporeally unassembling the assemblable medical device inside the subject’s body. In particular, the assemblable medical device may be pushed relative to the first implantable medical device component and the second implantable medical device component, and / or the first implantable medical device component and the second implantable medical device component may be pulled relative to the assemblable medical device for unassembling. A portion of the assemblable medical device (e.g., the elongated control structure 114 and the electrical lead 712) may be pushed from outside the subject’s body, such as through the second subject’s body access, for unassembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900) from each other inside the subject’s body. Additionally, or alternatively, the second implantable medical device component (e.g., the catheter 600) may be pulled from outside the subject’s body, such as through the first subject’s body access, for unassembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component 104 (e.g., the anchors 606, 1400, 1600, 1900) from each other inside the subject’s body.

[0207]

[0217] Additionally, or alternatively, a medical tool, such as a snare, may be introduced through the first subject’s body access in the vascular system and routed therein up to the assemblable medical device that is assembled to the implantable medical device. The medical tool is then manipulated to capture (also referred to herein as “to snare”) an optional capturable element (e.g., the capturable element 1214) of the assemblable medical device, and is pulled through the first subject’s body access for unassembling the assemblable medical device and the second implantable medical device component 104 from each other. The retrieval sheath may be railed over the medical tool up to the assemblable medical device. Then, the assemblable medical device is caused to enter the retrieval sheath (also referred to herein as “sheating”) by pulling the medical tool from the first subject’s body access and the retrieval sheath, and / or by pushing the retrieval sheath against the assemblable medical device.

[0208]

[0218] The assemblable medical device, the first implantable medical device component, the second implantable medical device component, and / or the linker may also be mechanically or electrically actuated for unassembling. In particular, the elongated control element (e.g. the electrical lead 712) of the assemblable medical device may be extracorporeally or intracorporeally actuated for intracorporeally unassembling the assemblable medical device (e.g., the functional unit 112) and the second implantable medical device component (e.g., the anchors 606, 1400, 1600, 1900) from each other. The actuation may be commanded extracorporeally from outside or intracorporeally from inside the subject’s body.

[0219] In an implementation, for example, the method 2600 includes: stopping 2606 the operation of the assemblable medical device, such as the functional unit thereof, being operated at the intraluminal implantation site. The assemblable medical device may be operated from outside the subject’s body by connecting it to a controller, or wirelessly. Unassembling 2608 the implanted medical device, such as the second implantable medical device component thereof, and the assemblable medical device, such as a functional unit thereof, from each other at the intraluminal implantation site by manipulating the implanted medical device and / or the assemblable medical device from outside the subject’s body. The implanted medical device and / or the assemblable medical device may be manipulated by pulling and / or pushing it or them for unassembling. Unanchoring 2604 the implanted medical device, such as the second implantable medical device component thereof, from the intraluminal implantation site. Transcatheterly explanting 2602 or transcatheterly retrieving the implanted medical device and the assemblable medical device, which is unassembled from the implanted medical device, from the vascular system of the subject.

[0209]

[0220] In this last implementation, as well as any other implementations herein, stopping 2606, unassembling 2608, unanchoring 2604, and explanting 2602 may be performed in any order, depending on the medical procedure.

[0210]

[0221] According to the methods 2500 and 2600, the first arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are linearly arranged relative to each other, and the second arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are non-linearly arranged relative to each other. The first and second arrangements may be as described herein for the implantable medical device 100.

[0211]

[0222] For example, the first arrangement may be a generally linear arrangement, and the second arrangement may be a generally nonlinear arrangement. Conversely, the first arrangement may be a generally nonlinear arrangement, and the second arrangement may be a generally linear arrangement. The first arrangement may be a generally curved arrangement, and the second arrangement may be a generally non-curved arrangement. Conversely, the first arrangement may be a generally non-curved arrangement or arrangement, and the second arrangement may be a generally curved arrangement. The first arrangement may be a generally angled arrangement, and the second arrangement may be a generally non-angled arrangement. Conversely, the first arrangement may be a generally non-angled arrangement, and the second arrangement may be a generally angled arrangement. The first arrangement may be a less resilient arrangement, and the second arrangement may be a comparatively more resilient arrangement. Conversely, the first arrangement may be a more resilient arrangement, and the second arrangement may be a comparatively less resilient arrangement. This may be the case when the resilience property of the linker 106 varies as the linker 106 is changed, converted, or transitioned between the first configuration and the second arrangements, such that the linker 106 has different resilience properties or capacities in the first configuration compared to the second configuration.

[0212]

[0223] The methods 2500 and 2600 may rely on a first subject’s body access and / or on a second subject’s body access, as the case may be, for implantation and explantation, respectively. Each of the first subject’s body access and the second subject’s body access may be a subject lower body access or a subject upper body access. Each of the first subject’s body access and the second subject’s body access may be a subject natural body access or a subject surgically made body access. For example, the first subject’s body access may be a subject lower body access, such as a subject femoral access, and the second subject’s body access may be subject upper body access, such as an axillary or subclavian access.

[0213]

[0224] It is noted that reference to the implantable medical device 100 and / or any other feature(s) described herein, as the case may be, is / are made for the sole purposes of describing how the methods 2500 and 2600 may be implemented and / or practiced. Accordingly, such reference is not intended to limit the scope of the method 2500. It is also noted that optional features are represented by dash lines in FIGS. 25 and 26.

[0214] Medical Snare Instrument

[0215]

[0225] According to another aspect, this disclosure also relates to a medical snare instrument 2800 that facilitates the capture of medical devices implanted at challenging implantation sites in a subject’s body. By way of example, as illustrated in FIG. 27, such a challenging implantation site may be a suprarenal site 2700 in the descending aorta 2702, where a transcatheterly implantable medical device 2704 is implanted with its driveline 2706 running along the aortic arch 2708 and the left subclavian artery 2710, according to an embodiment. So implanted, the driveline 2706 may, for example, cause a capturable portion 2712 of the transcatheterly implantable medical device 2704 to be pressed against the lumen wall of the aorta, hindering or preventing capture of the capturable portion 2712. In another implantation scenario, a challenging implantation site may be one where the capturable portion 2712 is positioned adjacent to a lumen wall, but not pressed against it. In all such instances, it may be difficult or impossible to capture the implanted medical device to explant it, for example.

[0216]

[0226] At a high level, referring to FIG. 28, there is schematically illustrated the medical snare instrument 2800 for capturing an implantable medical device, such as a transcatheterly implantable medical device, according to one or more embodiment(s). The medical snare instrument 2800 includes a first elongated body 2802, a capture element 2804 associated with the first elongated body 2802, and a second elongated body 2806. The capture element 2804 is convertible between a non-capturing configuration (e.g., as illustrated in FIGS. 29, 30, 32 and 34) and a capturing configuration (e.g., as illustrated in FIG. 33) for capturing the implantable medical device.

[0217]

[0227] The second elongated body 2806 has a projecting end portion 2808 that projects or protrudes beyond or away from the first elongated body 2802. The projecting end portion 2808 of the second elongated body 2806 has a terminal end portion 2810. At least one of the first elongated body 2802 and the terminal end portion 2810 is / are movable toward and / or closer the other one of the first elongated body 2802 and the terminal end portion 2810 for converting the capture element 2804 between the non-capturing configuration and the capturing configuration.

[0218]

[0228] As described in further details herein, the first elongated body 2802 may at least partially receive the second elongated body 2806 therein. The first elongated body 2802 may be slid over the projecting end portion 2808, along any given length portion thereof, until the capture element 2804 engages or abuts the terminal end portion 2810, such that the capture element 2804 is converted from the non-capturing configuration to the capturing configuration.

[0219]

[0229] As also described in further details herein, the capture element 2804 optionally includes at least one capture projection 2812 and / or a biasing element 2814. The terminal end portion 2810 of the second elongated body 2806 optionally includes a magnetizable element 2816. The medical snare instrument 2800 optionally includes an operator handle 2906, a first flush port 2820, a second flush port 2822, a third elongated body 2824 (not shown in FIG. 28 for clarity reasons, but shown in FIG. 36), and / or a sheath loader 2826 (not shown in FIG. 28 for clarity reasons, but shown in FIG. 38). It is noted that optional features are represented by dash lines in FIG. 28.

[0220]

[0230] Selected non-limiting example embodiments of the medical snare instrument 2800 will now be described in further detail.

[0221]

[0231] FIG. 29 illustrates the medical snare instrument 2800 with the capture element 2804 (partially visible in FIG. 29 since it is inside the sheath element 2900, but entirely visible, e.g., in FIG. 30) in the non-capturing configuration. The medical snare instrument 2800 includes: i. the first elongated body 2802 optionally provided as a sheath element 2900 (also referred to herein as a “tubular body”) that slidably receives the second elongated body 2806 (not visible in FIG. 29 since it is inside the sheath element 2900, but visible, e.g., in FIG. 30) therein; ii. the capture element 2804 optionally provided with a plurality of the capture projections 2812, such as three capture projections 2812, and also optionally provided with the biasing element 2814 (not visible in FIG. 29 since it is inside the sheath element 2900, but visible, e.g., in FIG. 30), which is provided as a compression spring 2908; iii. the second elongated body 2806 optionally provided as a wire 2902 having the projecting end portion 2808 and the terminal end portion 2810, the terminal end portion 2810 includes the magnetizable element 2816, which is provided as a permanent magnet 2904; and iv. the operator handle 2906, according to one or more embodiment s).

[0222]

[0232] It is to be noted that the overall length of the sheath element 2900 and wire 2902 is not to scale in FIG. 29 for illustration purposes. In the medical snare instrument 2800, the overall length of the sheath element 2900 and the wire 2902 may be between 60 to 100 centimeters, inclusively, such as 86 centimeters. Such length enables the sheath element 2900 and wire 2902 to be navigated from a lower body intracorporeal access, such as a percutaneous and / or transcatheter femoral access, up to a suprarenal implantation site in the descending aorta of a subject’s body.

[0223]

[0233] FIG. 30 illustrates the sheath element 2900, the wire 2902 with the permanent magnet 2904, and the capture element 2804 in the non-capturing configuration, according to one or more embodiment s). The sheath element 2900 has a lumen 3000 that extends between a first end portion 3002 (also referred to herein as a “proximal end portion”; not visible in FIGS. 30 since it is inside the sheath element 2900, but visible, e.g., in FIGS. 29 and 35-37) and a second end portion 3004 (also referred to herein as a “distal end portion”) of the sheath element 2900. At the at the second end portion 3004, the capture element 2804 has the compression spring 2908 thereof received within the lumen 3000, and the capture projections 2812 projecting outwardly from the lumen 3000.

[0224]

[0234] The wire 2902 is received within the lumen 3000, through the capture element 2804, and projects outwardly from the lumen 3000 such that the permanent magnet 2904 spaced apart from the second end portion 3004 of the sheath element 2900. As such, the sheath element 2900 and the wire 2902 are in a slidable relationship together where the sheath element 2900 is slidable over the wire 2902, which is fixed, for converting the capture element 2804 between the non-capturing configuration and the capturing configuration, as described herein.

[0225]

[0235] The sheath element 2900 may have various constructions. As illustrated in FIG. 30, for example, the sheath element 2900 includes a sheath portion 3006 and a sleeve portion 3008, which has an outer diameter that is larger than the outer diameter of the sheath portion 3006 for receiving the capture element 2804 therein, according to one or more embodiment(s). Alternatively, the sheath element 2900 may only be provided as the sheath portion 3006 which in this case is sized and shaped to receive the capture element 2804 therein.

[0226]

[0236] Still referring to FIG. 30, the capture element 2804 has a first end portion 3010 that is fixed within the lumen 3000 of the sheath element 2900, and a second end portion 3012 that is movable relative to the first end portion 3010, such that the compression spring 2908 can be compressed by the permanent magnet 2904, according to one or more embodiment s). The compression spring 2908 is associated with the first end portion 3010 of the capture element 2804, and the capture projections 2812 are associated with the second end portion 3012 of the capture element 2804. The compression spring 2908 is generally positioned within the lumen 3000 when the capture element 2804 is in the non-capturing and capturing configurations, as illustrated for example in FIGS. 30 and 33, respectively, according to one or more embodiment(s). The capture projections 2812 are generally positioned outside the lumen 3000 when the capture element 2804 is in the non-capturing configuration, as illustrated for example in FIGS. 30 and 32, according to one or more embodiment s), and are generally positioned within the lumen 3000 when the capture element 2804 is in the capturing configuration, as illustrated in FIG. 33, according to one or more embodiment(s).

[0227]

[0237] Still referring to FIG. 30 and as illustrated in FIG. 31, the capture element 2804 in the noncapturing configuration with the capture projections 2812 is shaped such that respective capture end portions 3018 (only two of the three are shown in FIG. 30) thereof describe an outer periphery 3100 that is larger than the outer diameter 3102 of the sheath element 2900, according to one or more embodiment(s). The capture projections 2812 are optionally biased for the capture end portion 3018 to describe the outer periphery 3100 when the capture element 2804 is in the noncapturing configuration.

[0228]

[0238] FIG. 32 illustrates the capture element 2804 still in the non-capturing configuration but with the capture projections 2812 shaped, bent, or curved such that the respective capture end portions 3018 thereof are positioned along an outer peripheral portion of the sheath element 2900, according to one or more embodiment(s). The capture end portions 3018 may be positioned at any distance from the sheath element 2900, along the outer peripheral portion thereof. The capture projections 2812 are optionally biased for the capture end portions 3018 to be positioned along the outer peripheral portion of the sheath element 2900 when the capture element 2804 is in the noncapturing configuration.

[0229]

[0239] Alternatively, the capture elements 2804 in the non-capturing configuration may have the capture end portions 3018 positioned farther from the from the sheath element 2900, along the outer peripheral portion thereof, than the permanent magnet 2904.

[0230]

[0240] As best illustrated in FIG. 31, for example, each capture projection 2812 includes two arms 3104, 3106 (shown for a single capture projection 21812) that together forms an apex 3108 (also shown for a single capture projection 21812) projecting from the capture element 2804, according to one or more embodiment s). The apex 3108 corresponds to the capture end portion 3018 of the capture projection 2812. It is to be noted that the operator handle 2818 is not illustrated in FIG. 31 for clarity reasons).

[0241] The two arms 3104, 3106 and the apex 3108 advantageously mitigates or prevents entanglement of the projecting end portion 2808 of the wire 2902 with the capture projections 2812 by providing a structure or support on which the capture projections 2812 may glide to disentangle, as the case may be.

[0231]

[0242] Referring back to FIG. 30, alternatively, the first end portion 3010 of the capture element 2804 may not be fixed inside the lumen 3000, such that the capture element 2804 may move or slide within the lumen 3000 until it is stopped by a structure of the sheath element 2900, such as by an abutment stop (not shown) within the lumen 3000, to be compressed by the permanent magnet 2904. The wire 2902 may alternatively be positioned along the compression spring 2908, between the compression spring 2908 and the lumen wall of the sheath element 2900. The compression spring 2908 may alternatively be located at the first end portion 3002 of the sheath element 2900 and / or may alternatively located within the operator handle 2906. The biasing element 2814 may alternatively be a tension spring (not shown) attached or coupled to the second end portion 3004 of the sheath element 2900 and the first end portion 3010 of the capture element 2804 for biasing the capture element 2804 toward the non-capturing configuration.

[0232]

[0243] Still referring to FIG. 30, the capture element 2804 optionally includes a stopper element 3014 that engages or abuts the permanent magnet 2904 for converting the capture element 2804 between the non-capturing configuration and the capturing configuration, according to one or more embodiment(s). The stopper element 3014 is generally disposed between the capture projections 2812 and the compression spring 2908, and optionally includes a recess portion 3016 sized and shaped for engaging or abutting the permanent magnet 2904. Alternatively, the capture element 2804 may be sized and shaped for the permanent magnet 2904 to engage or abut the capture projections 2812 and / or the compression spring 2908.

[0233]

[0244] The capture element 2804 optionally integrates the capture projections 2812, the compression spring 2908, and the stopper element 3014 as separate components, as illustrated, according to one or more embodiment(s). Alternatively, the capture element may be an integral, one-piece construction. One or more of the capture projections 2812, the compression spring 2908, and the stopper element 3014 may be made of a resilient material and / or a shape-memory material, such as nitinol, stainless steel, and biocompatible polymers.

[0245] When the capture element 2804 is in the non-capturing configuration, referring to FIGS. 30-32, for example, the capture projections 2812 project outwardly from the lumen 3000 of the sheath element 2900, at the second end portion 3004 thereof, and the compression spring 2908 is in an unloaded configuration (also referred to herein as an “uncompressed configuration”), maintaining the capture projections 2812 in the non-capturing configuration, according to one or more embodiment(s).

[0234]

[0246] When the capture element 2804 is in the capturing configuration, as illustrated in FIG. 33, for example, the capture projections 2812 are disposed within the lumen 3000 of the sheath element 2900, at the second end portion 3004 thereof, and the compression spring 2908 is in a loaded configuration (also referred to herein as a “compressed configuration”), according to one or more embodiment(s). The capture projections 2812 are each shaped in a generally linear arrangement when received within the lumen 3000, and are optionally non-biased toward this arrangement. The capture projections 2812 and the corresponding capture end portions 3018 thereof may be positioned anywhere within the lumen 3000 along the length of the sheath element 2900.

[0235]

[0247] As illustrated in FIGS. 30-33, for example, each capture end portion 3018 includes a respective protrusion 3110, according to one or more embodiment s). When the capture element 2804 is in the capturing configuration, as illustrated in FIG. 33, the protrusions 3110 collectively block or close the lumen 3000 of the sheath element 2900, at the second end portion 3004 thereof, to capture or retain the implantable medical device therein. The protrusions 3110 are atraumatic in the context where the medical snare instrument 2800 is used inside a subject’s body, such as during a transcatheter intervention, and can function, for example, as bumpers against an anatomical structure, such as a lumen wall. Accordingly, the protrusions 3110 may be made of a biocompatible soft material.

[0236]

[0248] Alternatively, each capture end portion 3018 may include a jaw or a loop sized and shaped to engage an implantable medical device to capture the same, as described herein, with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable. Any number of capture projections 2812 may be provided to the capture element 2804. Such jaw and loop may also be atraumatic and function as bumper, as described herein.

[0249] Referring to FIGS. 30 and 34, for example, the wire 2902 extends between a first end portion 3020 (also referred to herein as a “proximal end portion”; not visible in FIGS. 30 and 34 since it is inside the sheath element 2900, but visible, e.g., in FIG. 35) and a second end portion 3022 (also referred to herein as a “distal end portion”) thereof, and the permanent magnet 2904 is attached or coupled to the second end portion 3022, according to one or more embodiment s).

[0237]

[0250] As illustrated in FIG. 30, with the capture element 2804 in the non-capturing configuration, the projecting end portion 2808 of the wire 2902 projects outwardly from the lumen 3000 of the sheath element 2900 and is generally linear such that the permanent magnet 2904 is positioned away or distally from the second end portion 3004 of the sheath element 2900, according to one or more embodiment(s).

[0238]

[0251] Alternatively, as illustrated in FIG. 34, with the capture element 2804 still in the noncapturing configuration, the projecting end portion 2808 of the wire 2902 optionally projects outwardly from the lumen 3000 of the sheath element 2900 and is generally shaped, bent, or curved such that the permanent magnet 2904 is positioned along the outer peripheral portion of the medical snare instrument 2800, according to one or more embodiment(s). The permanent magnet 2904 of the wire 2902 may be positioned along the outer peripheral portion of the medical snare instrument 2800, while the capture end portions 3018 of the capture element 2804 in the noncapturing configuration may be positioned along the outer peripheral portion of the sheath element 2900. The projecting end portion 2808 of the wire 2902 is optionally biased for the permanent magnet 2904 to be positioned along the outer peripheral portion of the sheath element 2900.

[0239]

[0252] The positioning of the permanent magnet 2904 along the outer peripheral portion of the medical snare instrument 2800 advantageously enables rotation of the medical snare instrument 2800, such that the permanent magnet 2904 can explore a cross-sectional area of a subject’s body lumen, such as a vascular lumen of the cardiovascular system, to establish magnetic interaction with an implanted medical device. Such arrangement of the projecting end portion 2808 of the wire 2902 also advantageously facilitates intraluminal or intracorporeal navigation of the medical snare instrument 2800 through a difficult angle, similar to a J-tip guidewire. When both the permanent magnet 2904 and the capture projections 2812 are positioned along their respective outer peripheral portions, the positioning of the permanent magnet 2904 farther away from the sheath element 2900 than the capture end portions 3018 advantageously mitigates or prevents entanglement of the wire 2902 with the capture projections 2812. Such entanglement may occur, for example, when the medical snare instrument 2800 is rotated, as described herein. Finally, the wire 2902 with the permanent magnet 2904 magnetically contacting an implanted medical device is advantageously used to rail the sheath element 2900 over the projecting portion 2808 to guide the capture element 2804 toward the implanted medical device for capturing the same.

[0240]

[0253] Referring back to FIG. 33, with the capture element 2804 in the capturing configuration, the projecting end portion 2808 of the wire 2902 is received within the lumen 3000 of the sheath element 2900 and is shaped in a generally linear arrangement therein, according to one or more embodiment(s). The permanent magnet 2904 is positioned within an area 3300 defined by the capture projections 2812. The area 3300 includes a space bordered by the permanent magnet 2904 and the projecting end portions 2808 of the capture projections 2812. The space is generally sized and shaped to accommodate a capturable portion 3302 of an implantable medical device therein. The capture projections 2812, the capture end portions 3018, and the permanent magnet 2904, may be positioned anywhere within the lumen 3000 along the length of the sheath element 2900.

[0241]

[0254] The wire 2902 may be made of a resilient material and / or a shape-memory material, such as nitinol, stainless steel, and biocompatible polymers. The permanent magnet 2904 may be provided as a neodymium magnet. The magnetizable element 2816 may include an electromagnet configured to be operated through the second elongated body, or may be ferromagnetic.

[0242]

[0255] The capture element 2804 is converted from the non-capturing configuration to the capturing configuration by moving, sliding, or pushing (as represented by a bold arrow in FIG. 30) the sheath element 2900 along a given length portion 3024 of the projecting end portion 2808 of the wire 2902 toward the permanent magnet 2904, until the capture element 2804 engages or abuts the permanent magnet 2904. At this point, the permanent magnet 2904 compresses the compression spring 2908, and the capture projections 2812 are forced within the lumen 3000 of the sheath element 2900, thereby converting from the non-capturing configuration to the capturing configuration. Doing so, as described herein, the capture projections 2812 of the capture element 2804 and / or the projecting end portion 2808 of the wire 2902 respectively convert(s) from an arrangement illustrated in FIGS. 30, 32, and 34, as the case may be, to a generally linear arrangement as illustrated in FIGS. 33, and the compression spring 2908 converts from the unloaded configuration to the loaded configuration.

[0243]

[0256] Conversely, the capture element 2804 is converted from the capturing configuration to the non-capturing configuration by moving, sliding, or pulling (as represented by a bold arrow in FIG. 33) the sheath element 2900 away from the permanent magnet 2904, releasing the tension caused by of the wire 2902 and the permanent magnet 2904 that keeps the compression spring 2908 compressed. Doing so, as described herein, the capture projections 2812 of the capture element 2804 convert from a generally linear arrangement, as illustrated in FIG. 33, to an arrangement illustrated in FIGS. 30 and 32, as the case may be, and the compression spring 2908 converts from the loaded configuration to the unloaded configuration. Pass this point, the capture element 2804 disengages or “un-abuts” the permanent magnet 2904, and the sheath element 2900 is further moved, slid, or pulled back into place along the given length portion 3024 of the projecting end portion 2808 of the wire 2902. Doing so, the projecting end portion 2808 converts from a generally linear arrangement, as illustrated in FIG. 33, to an arrangement illustrated in FIGS. 30 and 34, as the case may be.

[0244]

[0257] The given length portion 3024 of the projecting end portion 2808 of the wire 2902 generally has a length appropriate to establish an appropriate magnetic interaction between the permanent magnet 2904 and an implanted medical device, while providing the required clearance between the second end portion 3004 of the sheath element 2900 and the permanent magnet 2904 for the capture projections 2812 to function appropriately to capture the implanted medical device. Additionally, or alternatively, the given length portion 3024 may also have a length appropriate for intraluminal or intracorporeal navigation of the medical snare instrument 2800 through a difficult angle, particularly when the projecting end portion 2808 of the wire 2902 bent or curved similar to a J-tip guidewire.

[0245]

[0258] The medical snare instrument 2800 may alternatively have other arrangements. For example, the sheath element 2900 and the wire 2902 may be in a slidable relationship together where the wire 2902 is slidable within the lumen 3000 of the sheath element 2900, which is fixed, for converting the capture element 2804 between the non-capturing configuration and the capturing configuration, as described herein. The sheath element 2900 and the wire 2902 may also be in a slidable relationship together where the wire 2902 and the sheath element 2900 are both slidable relative to each other — no one being fixed — for converting the capture element 2804 between the non-capturing configuration and the capturing configuration, as described herein. In these cases, the operation of the medical snare instrument 2800 and conversion of the capture element 2804 between the non-capturing configuration and the capturing configuration are similar to what is already described herein, with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable.

[0246]

[0259] Additionally, or alternatively, the wire 2902 may be disposed along the outside of the sheath element 2900, and the second end portion 3004 of the sheath element 2900 may have a longitudinal slot (not shown) configured to slidably receive the projecting end portion 2808 of the wire 2902 therein for the permanent magnet 2904 to engage or abut, and disengage or “un-abuf ’ the capture element 2804.

[0247]

[0260] FIG. 35 illustrates the medical snare instrument 2800 with the operator handle 2906 coupled to the first end portion 3002 of the sheath element 2900 and the first end portion 3020 of the wire 2902, according to one or more embodiment s). The wire 2902 is fixed to the operator handle 2906 by the fixation 3500. The operator handle 2906 optionally includes a control element 3502 that selectively control the conversion of the capture element 2804 between the non-capturing configuration and the capturing configuration. In particular, the control element 3502 is attached or coupled to the first end portion 3002 of the sheath element 2900 and is movable or slidable relative to the operator handle 2906 to correspondingly move or slide the sheath element 2900 over the wire 2902 received within the lumen 3000 of the sheath element 2900, thereby progressively controlling the conversion of the capture element 2812 between the non-capturing and the capturing configurations, as described herein.

[0248]

[0261] Alternatively, the sheath element 2900 may be fixed to the operator handle 2906, and the control element 3502 may be attached or coupled to the first end portion 3020 of the wire 2902 to move or slide the wire 2902 received within the lumen 3000 of the sheath element 2900 for the same purpose. Still alternatively, a first control element (also referred to herein as a “sheath element control element”) may be attached or coupled to the first end portion 3002 of the sheath element 2900, and a second control element (also referred to herein as a “wire control element”) may be attached or coupled to the first end portion 3020 of the wire 2902 such that the first and second control elements are movable or slidable relative to each other for the same purpose.

[0249]

[0262] Referring back to FIG. 29, the operator handle 2906 optionally includes a locking mechanism 2910 that selectively locks the capture element 2804 in the capturing configuration, according to one or more embodiment(s). In particular, the operator handle 2906 includes a longitudinal track 2912 and a transversal track 2914. The longitudinal track 2912 longitudinally slidably guides the control element 3502 on the operator handle 2906 for converting the capture element 2804 between non-capturing and the capturing configuration. The transversal track 2914 transversally slidably guides the control element 3502 on the operator handle 2906 for locking the capture element 2804 in the capturing configuration.

[0250]

[0263] Advantageously, the medical snare instrument 2800 is configured to be operated singlehandedly by an operator via the operator handle 2906. Indeed, the action of the compression spring 2908 in biasing simplifies the operator’s manipulation by automatically returning the capture element 2804 to the non-capturing configuration and maintaining it in this configuration without requiring any manipulation from the operator other than actuating the control element 3502. It is to be noted that springing action of the capture projections 2812 caused by their biasing action is insufficient for the capture element 2804 to convert from the non-capturing configuration to the capturing configuration, notably when the capture projections 2812 are fully received within the lumen 3000 of the sheath element 2900. Further, the locking mechanism 2910 is single-handedly operable by a thumb of the operator to lock the capture element 2804 in the capturing configuration. Still further, with the permanent magnet 2904 positioned in the outer peripheral portion of the medical snare instrument 2800, the medical snare instrument 2800 is also singlehandedly rotatable by an operator to establish a magnetic interaction with an implanted medical device, as described. Altogether, this allows the operator to keep its second hand for other tasks.

[0251]

[0264] FIG. 36 illustrates the medical snare instrument 2800 with the third elongated body 2824 provided as an overlapping sheath 3600, which is fixed to the operator handle 2906 and slidably receives the sheath element 2900 therein, according to one or more embodiment(s). Such movement may be, for example, the movement or sliding of the sheath element 2900 caused by the control element 3502.

[0265] Advantageously, the overlapping sheath 3600 prevents the movement or sliding of the sheath element 2900 from unwanted friction against a hemostatic valve (not shown) that receives the sheath element 2900 therethrough, as it may be the case in the context of a medical intervention.

[0252]

[0266] Still referring to FIGS. 36-37, the medical snare instrument 2800 includes the first flush port 2820 and the second flush port 2822, according to one or more embodiment(s). As illustrated in FIG. 36, the first flush port 2820 is in fluid communication with the overlapping sheath 3600 for flushing the lumen thereof that slidably receives the sheath element 2900 therein. The fluid path of the first flush port 2820 is represented by an arrow in FIG. 36. As illustrated in FIGS. 36- 37, the second flush port 2822 is in fluid communication with a tube 3602, which is fixed by the fixation 3604 to the operator handle 2906 and is slidably and sealingly received within the lumen 3000 of the sheath element 2900. The tube 3602 receives the wire 2902 in its lumen. The second flush port 2822is for flushing the lumen 3000 of the sheath element 2900. The fluid path of the second flush port 2822 is represented by an arrow in FIG. 36.

[0253]

[0267] FIG. 38 illustrates the medical snare instrument 2800 that includes the sheath loader 2826 (also referred to herein as a “fourth elongated body”), according to one or more embodiment(s). The sheath loader 2826 includes a loader sheath element 3800 (shown in transparency in FIG. 38 to see the sheath element 2900 received therein) and a sheath loader flush port 3802 in fluid communication with the loader sheath element 3800 for flushing the same. The loader sheath element 3800 receives at least partially the sheath element 2900 or, optionally, the overlapping sheath element 2900 therein, as the case may be. The sheath loader 2826, when receiving the sheath element 2900 or, optionally, the overlapping sheath element 2900, provides additional stiffness to the medical snare instrument 2800, such that the sheath element 2900 or the overlapping sheath element 2900 can be appropriately passed through a hemostatic valve, as it may be the case in the context of a medical intervention.

[0254] Method of Using a Medical Snare Instrument

[0255]

[0268] According to another aspect, as illustrated in FIG. 39, this disclosure also relates to a method 3900 of using a medical snare instrument (e.g., the medical snare instrument 2800) to capture a medical device (e.g., a transcatheterly implantable medical device) implanted in a subject’s body (e.g., in a cardiovascular system thereof). The medical snare instrument includes a first instrument portion (e.g., the first elongated body 2802 or the sheath element 2900) and a second instrument portion (e.g., the second elongated body 2806 or the wire 2900) that projects beyond the first instrument portion. The method includes establishing a magnetic interaction between the second instrument portion of the medical snare instrument and the medical device; and moving at least one of the first instrument portion and the second instrument portion toward the other one of the first instrument portion and the second instrument portion to capture the medical device. For example, the sheath element 2900 and the capture element 2804 may be moved, relative to the wire 2902, toward the permanent magnet 2904 magnetically interacting with the medical device for the capture projections 2812 to capture the medical device.

[0256]

[0269] According to the method 3900, the second instrument portion may include a magnetizable element, such as the permanent magnet 2904, that is positioned along an outer peripheral portion of the first instrument portion. The method may include rotating the medical snare instrument to establish the magnetic interaction. For example, the operator handle 2906 of the medical snare instrument 2800 may be rotated by an operator to correspondingly rotate the permanent magnet 2904, which is in the positioned along the outer peripheral portion of the second instrument portion, of the wire 2902 within a lumen of a subject’s cardiovascular system for the permanent magnet 2904 to establish a magnetic interaction with the medical device implanted within the lumen of a subject’s cardiovascular system.

[0257]

[0270] Establishing 3902 may include establishing a magnetic contact between the magnetizable element and the medical device.

[0258]

[0271] Moving 3904 may include sliding the first instrument portion toward the second instrument portion to capture the medical device. For example, the sheath element 2900 and the capture element 2804 may be slid, relative to the wire 2902, toward the permanent magnet 2904 magnetically interacting with the medical device for the capture projections 2812 to capture the medical device.

[0259]

[0272] Moving 3904 may include sliding the first instrument portion along the second instrument portion until the first instrument portion engages the second instrument portion to capture the medical device. For example, the sheath element 2900 and the capture element 2804 may be slid, relative to the wire 2902, until the permanent magnet 2904 engages the capture element 2804 to capture the medical device.

[0260]

[0273] Moving 3904 may include sliding the second instrument portion toward the first instrument portion to capture the medical device. For example, the permanent magnet 2904, magnetically interacting with the medical device, may be slid relative to the sheath element 2900 and the capture element 2804 in a direction that moves the permanent magnet 2904 toward the sheath element 2900 and the capture element 2804 to capture the medical device.

[0261]

[0274] Moving 3904 may include sliding the second instrument portion along the first instrument portion until the second instrument portion engages the first instrument portion to capture the medical device. For example, the wire 2902 may be slid, relative to the sheath element 2900 and the capture element 2804, until the capture element 2804 engages the permanent magnet 2904 to capture the medical device.

[0262]

[0275] The method 3900 may include sliding a control element, such as the control element 3502, of the medical snare instrument to move the first instrument portion toward the second instrument portion to capture the medical device, and / or to move the second instrument portion toward the first instrument portion to capture the medical device.

[0263]

[0276] The method 3900 may include locking the control element for the medical device to remain captured by the medical snare instrument. For example, the control element 3502 may be slid transversally relative to the operator handle 2906 to lock the capture element 2804 in the capturing configuration and capture the medical device.

[0264]

[0277] According to the method 3900, the first instrument portion is associated with a plurality of capture projections having corresponding capture end portions 3018 peripherally located along an outer peripheral portion of the second instrument portion, said moving 3904 causes the plurality of capture projections to relocate at least partially inside the second instrument portion. For example, moving one of the sheath element 2900 and the wire 2902 relative to the other one of the sheath element 2900 and the wire 2902 may cause the capturing end portions 3018 of the capture projections 2812 to convert from generally bent or curved arrangement to a generally linear arrangement in which the capture projections 2812 are located within the lumen 3000 of the sheath element 2900.

[0265]

[0278] Establishing 3902 may be performed by a single hand of an operator.

[0266]

[0279] Moving 3904 may be performed by a single hand of an operator.

[0267]

[0280] Locking the control element may be performed by a single hand of an operator.

[0268]

[0281] The method may include retrieving the medical snare instrument from the subject’s body to explant the medical device implanted from the subject’s body. In particular, retrieving the medical snare instrument from the subject’s body may include pulling the medical snare instrument from the subject’s body. For example, the medical snare instrument may be retrieved through a lower body intracorporeal access, such as a percutaneous and / or transcatheter femoral access, of the subject’s body, and the medical device is explanted through the lower body intracorporeal access of the subject’s body. Also, a body of the medical device may be explanted first, followed by a driveline configured for the body to be operated therethrough. The medical device may be a transcatheterly implantable medical device in which the body is a blood pump, and the driveline is an electrical cable.

[0269]

[0282] Although the method 3900 is described herein as being performed on a medical device implanted in a subject’s body, it will be appreciated that the method 3900 may also be performed in other context, such as ex vivo, with the necessary change(s), appreciable to the skilled addressee, having been made, if applicable. For example, the method 3900 may be performed in the context of manufacturing and / or assembling a medical snare instrument, such as the medical snare instrument 2800 as part of a quality control process.

[0270]

[0283] It is noted that reference to the medical snare instrument 2800 and / or any other feature(s) described herein, as the case may be, is / are made for the sole purposes of describing how the method 3900 may be implemented and / or practiced. Accordingly, such reference is not intended to limit the scope of the method 3900. Definitions

[0271]

[0284] The terms “comprising”, “including”, “having”, and variations thereof shall be construed herein as open-ended terms and therefore are not intended to exclude other features, steps, and the like.

[0272]

[0285] The expression “and / or” is intended herein to indicate that one or more of a features, steps, and the like so recited may be included or may occur. For example, a device comprising / including a first element, a second element, and / or a third element is intended to be construed as any one of the following structural arrangements: (i) a device comprising / including the first element; (ii) a device comprising / including the second element; (iii) a device comprising / including the third element; (iv) a device comprising / including the first element and the second element; (v) a device comprising / including the first element and the third element; (vi) a device comprising / including the second element and the third element; or (vii) a device comprising / including the first element, the second element, and the third element.

Claims

1. CLAIMS1. An implantable medical device, comprising:- a first implantable medical device component having a first end portion and a second end portion;- a second implantable medical device component having a first end portion and a second end portion; and- a linker configured to link the first end portion of the first implantable medical device component and the second implantable medical device component together, wherein the linker is further configured for the implantable medical device to change between a first arrangement and a second arrangement when a force is applied to at least one of the first implantable medical device component and the second implantable medical device component.

2. The device according to claim 1, wherein the first arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are linearly arranged relative to each other, and the second arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are non-linearly arranged relative to each other.

3. The device according to any one of claims 1-2, wherein the first implantable medical device component is configured to be navigable in a subject’s body.

4. The device according to any one of claims 1-3, wherein the first implantable medical device component is configured to be navigable in a cardiovascular system of a subject’s body.

5. The device according to any one of claims 1-4, wherein the first implantable medical device component includes a flexible portion that at least partially extends between the first end portion and the second end portion of the first implantable medical device component.

6. The device according to any one of claims 1-5, wherein the first implantable medical device component is steerable in a subject’s body.

7. The device according to any one of claims 1-6, wherein the first implantable medical device component is configured to be extracorporeally manipulated for intracorporeally moving the second implantable medical device component.

8. The device according to any one of claims 1-7, wherein the second implantable medical device component comprises a helical-like structure extending between the first end portion and the second end portion of the second implantable medical device component.

9. The device according to any one of claims 1-8, wherein the second implantable medical device component comprises a stent-like structure extending between the first end portion and the second end portion of the second implantable medical device component.

10. The device according to any one of claims 1-9, wherein the second implantable medical device component comprises a plurality of longitudinal struts extending between the first end portion and the second end portion of the second implantable medical device component.

11. The device according to any one of claims 1-7, wherein the second implantable medical device component comprises a post extending between the first end portion and the second end portion of the second implantable medical device component, and a plurality of anchoring elements projecting from the post, the anchoring elements being configured to anchor the post in a subject’s body.

12. The device according to claim 11, wherein the anchoring elements project substantially radially from the post.

13. The device according to any one of claims 11-12, wherein the anchoring elements are grouped in two or more clusters that are axially spaced apart from each other along the post.

14. The device according to any one of claims 11-13, wherein each anchoring element comprises a respective engagement portion configured to atraumatically engage an anatomical structure in a subject’s body.

15. The device according to claim 14, wherein the engagement portion is configured to engage the anatomical structure and to be moved by manipulation of the first implantable medical device component without damaging the anatomical structure.

16. The device according to any one of claims 11-15, wherein the anchoring elements comprises a plurality of anchoring loop.

17. The device according to any one of claims 11-16, wherein the anchoring elements comprises a plurality of anchoring struts.

18. The device according to claim 11-17, wherein the post is inflexible.

19. The device according to any one of claims 11-18, wherein the linker is the post, the anchoring elements projecting from the linker.

20. The device according to claim 19, wherein the anchoring elements project substantially radially from the linker.

21. The device according to any one of claims 19-20, wherein the anchoring elements are grouped in two or more clusters that are axially spaced apart from each other along the linker.

22. The device according to any one of claims 19-21, wherein each anchoring element comprises a respective engagement portion configured to atraumatically engage an anatomical structure.

23. The device according to claim 22, wherein the engagement portion is configured to engage the anatomical structure in a subject’s body and to be moved by manipulation of the first implantable medical device component without damaging the anatomical structure.

24. The device according to any one of claims 19-23, wherein the anchoring elements comprises a plurality of anchoring loop.

25. The device according to any one of claims 19-24, wherein the anchoring elements comprises a plurality of anchoring struts.

26. The device according to any one of claims 1-25, wherein the linker is configured to link the first end portion of the first implantable medical device component and the second end portion of the second implantable medical device component together, the secondimplantable medical device component projecting away from the linker when coupled thereto.

27. The device according to claim 26, wherein the second implantable medical device component is substantially coaxially with the linker when coupled thereto.

28. The device according to claim 27, wherein the second implantable medical device component projects at an angle from the linker when coupled thereto.

29. The device according to claim 28, wherein the angle is one of 1-10 degree, 10-20 degree, 20-30 degree, 30-40 degree, 40-50 degree, 50-60 degree, 60-70 degree, 70-80 degree, and 80-90 degree.

30. The device according to any one of claims 1-10, wherein the linker and the second end portion of the second implantable medical device component are configured to couple together, the second implantable medical device component projecting along and overlapping with the linker when coupled thereto.

31. The device according to claim 30, wherein the second implantable medical device component is substantially coaxially with the linker when coupled thereto.

32. The device according to any one of claims 30-31, wherein the linker and the first end portion of the second implantable medical device component are configured to couple together.

33. The device according to any one of claims 1-10, wherein the second implantable medical device component is collapsible or compactable or compressible or contractible or foldable or retractable for decreasing a volume thereof.

34. The device according to any one of claims 1-10, wherein the second implantable medical device component is de / un-foldable or dilatable or enlargeable or expandable or extendable for increasing a volume thereof.

35. The device according to any one of claims 1-10, wherein the second implantable medical device component comprises a non-expanded configuration for delivery of the implantable medical device in a subject’s body.

36. The device according to claim 35, wherein the non-expanded configuration is a collapsed or compacted or compressed or contracted or folded or retracted configuration.

37. The device according to any one of claims 35-36, wherein the second implantable medical device component comprises an expanded configuration for anchoring the implantable medical device in a subject’s body.

38. The device according to claim 37, wherein the expanded configuration is a de / un-folded or dilated or enlarged or expanded or extended configuration.

39. The device according to any one of claims 37-38, wherein the second implantable medical device component is overcomeably biased toward the expanded configuration.

40. The device according to any one of claims 1-39, wherein at least one of the first implantable medical device component, the second implantable medical device component, and the linker comprises a capturable element configured to be captured by a medical tool in a subject’s body.

41. The device according to claim 40, wherein the capturable element is a snareable element configured to be snared by a medical tool in a subject’s body.

42. The device according to any one of claims 40-41, wherein the capturable element projects from the first end portion of the second implantable medical device component.

43. The device according to any one of claims 40-42, wherein the capturable element comprises stem and a protrusion, the stem linking the protrusion to the first end portion of the second implantable medical device component.

44. The device according to any one of claims 40-43, wherein the capturable element is magnetizable.

45. The device according to any one of claims 40-43, wherein the capturable element comprises a magnet.

46. The device according to any one of claims 1-45, wherein the linker is resilient.

47. The device according to any one of claims 1-46, wherein the linker is flexible.

48. The device according to any one of claims 1-47, wherein the linker is bendable.

49. The device according to any one of claims 1-48, wherein the linker comprises a flexible joint.

50. The device according to any one of claims 1-49, wherein the linker comprises a hinge.

51. The device according to any one of claims 1-50, wherein the linker comprises a pivot point.

52. The device according to any one of claims 1-51, wherein the linker is overcomeably biased toward a substantially linear arrangement.

53. The device according to any one of claims 1-52, wherein the linker is configured to flex, pivot, or hinge by at least 5-75 degree when subjected to a force of at least 0.1 Newton.

54. The device according to any one of claims 1-53, wherein the linker is made of a shapememory material.

55. The device according to any one of claims 1-54, wherein the linker is made of a material comprising: alloy, nitinol, stainless steel, polymer, or any combination thereof.

56. The device according to any one of claims 1-55, further comprising: a functional unit, the functional unit and the first end portion of the first implantable medical device component being configured to be couplable together.

57. The device according to claim 56, wherein the functional unit is an anchor configured to anchor the first end portion of the first implantable medical device component in a subject’s body.

58. The device according to any one of claims 1-57, further comprising: an assemblable medical device configured to assemble to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

59. The device according to claim 58, wherein the assemblable medical device is configured to unassemble from the at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

60. The device according to any one of claims 58-59, wherein the assemblable medical device is in a slidable relationship with at least one of the first implantable medical device component, the second implantable medical device component, and the linker for assembling the assemblable medical device to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

61. The device according to any one of claims 58-60, wherein the assemblable medical device is in a slidable relationship with at least one of the first implantable medical device component, the second implantable medical device component, and the linker for unassembling the assemblable medical device from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

62. The device according to any one of claims 58-61, wherein the assemblable medical device comprises a functional unit having a first end portion and a second end portion, and an elongated control structure having a first end portion and a second end portion; the second end portion of the functional unit being attached to the first end portion of the elongated control structure.

63. The device according to claim 62, wherein the elongated control structure is configured to be positioned along at least one of the first implantable medical device component, the second implantable medical device component, and the linker for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

64. The device according to any one of claims 62-63, wherein the elongated control structure is configured to be positioned along at least one of the first implantable medical device component, the second implantable medical device component, and the linker forunassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

65. The device according to any one of claims 62-64, wherein the elongated control structure is configured to be positioned through at least one of the first implantable medical device component, the second implantable medical device component, and the linker for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

66. The device according to any one of claims 62-65, wherein the elongated control structure is configured to be positioned through at least one of the first implantable medical device component, the second implantable medical device component, and the linker for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

67. The device according to any one of claims 65-66, wherein the first implantable medical device component comprises a guide hole configured to receive the elongated control structure therein for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

68. The device according to claim 67, wherein the guide hole is configured to receive the elongated control structure therein for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

69. The device according to any one of claims 65-68, wherein the guide hole is configured to slidably receive the elongated control structure therethrough.

70. The device according to any one of claims 67-69, wherein the first implantable medical device component comprises a longitudinal guide channel that at least partially extends longitudinally between the first end portion and the second end portion of the firstimplantable medical device component; the longitudinal guide channel being configured to receive the elongated control structure therein for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

71. The device according to claim 70, wherein the longitudinal guide channel is configured to receive the elongated control structure therein for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

72. The device according to any one of claims 70-71, wherein the longitudinal guide channel is configured to slidably receive the elongated control structure therethrough.

73. The device according to any one of claims 70-72, wherein the elongated control structure comprises an abutment stop configured to abut the second end portion of the first implantable medical device component.

74. The device according to any one of claims 62-73, wherein the elongated control structure is configured to be actuatable for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

75. The device according to any one of claims 62-74, wherein the elongated control structure is configured to be actuatable for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

76. The device according to any one of claims 74-75, wherein the elongated control structure is configured for the functional unit to be operated therethrough.

77. The device according to any one of claims 74-76, wherein the elongated control structure is mechanically actuatable for the functional unit to be operated therethrough.

78. The device according to any one of claims 62-77, wherein the elongated control structure is configured to be moved relative to at least one of the first implantable medical devicecomponent, the second implantable medical device component, and the linker for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

79. The device according to any one of claims 62-78, wherein the elongated control structure is configured to be moved relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

80. The device according to any one of claims 62-79, wherein the elongated control structure is configured to be manipulated for assembling the functional unit to at least one of first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

81. The device according to any one of claims 62-80, wherein the elongated control structure is configured to be manipulated, at the second end portion of the first implantable medical device component, for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker, at the first end portion of the first implantable medical device component.

82. The device according any one of claims 62-81, wherein the elongated control structure is configured to be extracorporeally manipulated for intracorporeally assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

83. The device according to any one of claims 62-82 wherein the elongated control structure is configured to be pulled for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

84. The device according to any one of claims 62-83, wherein the elongated control structure is configured to be manipulated for unassembling the functional unit from at least one of the-first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

85. The device according to any one of claims 62-84, wherein the elongated control structure is configured to be manipulated, at the second end portion of the first implantable medical device component, for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker, at the first end portion of the first implantable medical device component.

86. The device according any one of claims 62-85, wherein the elongated control structure is configured to be extracorporeally manipulated for intracorporeally unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

87. The device according to any one of claims 62-86, wherein the elongated control structure is configured to be pushed for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

88. The device according to any one of claims 62-87, wherein the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker are configured to abut, contact, connect, dock, engage, and / or mate together for assembling the functional unit to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

89. The device according to any one of claims 62-88, wherein the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker are configured to de / un-abut, de / un-contact, de / un- connect, de / un-dock, dis / un-engage, and / or de / un-mate from each other for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

90. The device according to any one of claims 62-89, wherein the functional unit and the first end portion of the first implantable medical device component are configured to assemble together in a subject’s body.

91. The device according to any one of claims 62-90, wherein the functional unit and the first end portion of the first implantable medical device component are configured to unassemble from each other in a subject’s body.

92. The device according to any one of claims 62-91, wherein at least one of the first implantable medical device component, the second implantable medical device component, and the linker comprises a first assembling element configured to couple the functional unit for assembling the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker together in a subject’s body.

93. The device according to claim 92, wherein the first assembling element is configured to uncouple the functional unit for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

94. The device according to any one of claims 92-93, wherein the second implantable medical device component comprises the first assembling element.

95. The device according to any one of claims 92-94, wherein the functional unit comprises a second assembling element configured to couple at least one of the first implantable medical device component, the second implantable medical device component, and the linker for assembling the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker together in a subject’s body.

96. The device according to claim 95, wherein the second assembling element is configured to uncouple at least one of the first implantable medical device component, the second implantable medical device component, and the linker for unassembling the functional unitfrom at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

97. The device according to any one of claims 92-96, wherein the first assembling element and the second assembling element are configured to couple together for assembling the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker together in a subject’s body.

98. The device according to any one of claims 92-97, wherein the first assembling element and the second assembling element are configured to uncouple from each other for unassembling the functional unit from at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

99. The device according to any one of claims 92-98, wherein the first assembling element comprises an opening configured to slidably receive the elongated control structure therethrough.

100. The device according to claim 99, wherein the opening is configured to slidably engage the functional unit thereto.

101. The device according to claim 99-100, wherein the opening is configured to removably engage the functional unit thereto.

102. The device according to any one of claims 99-101, wherein the opening is configured to slidably abut an elongated control structure projecting portion of the functional unit thereagainst.

103. The device according to claim 102, wherein the opening is configured to removably abut the functional unit thereagainst.

104. The device according to any one of claims 99-103, wherein the opening is configured for the functional unit to be immobilized in the opening when the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker are assembled together in a subject’s body.

105. The device according to any one of claims 99-103, wherein the opening is configured for the functional unit to be free floating in the opening when the functional unit and at least one of the medical device component, the second implantable medical device component, and the linker are assembled together in a subject’s body.

106. The device according to any one of claims 99-105, wherein the opening is collapsible or compactable or compressible or contractible or foldable or retractable.

107. The device according to any one of claims 99-106, wherein the opening is defoldable or dilatable or enlargeable or expandable or extendable.

108. The device according to any one of claims 99-107, wherein the opening comprises an undeployed configuration for delivery of the implantable medical device in a subject’s body.

109. The device according to claim 108, wherein the undeployed configuration is a collapsed or compacted or compressed or contracted or folded or retracted configuration.

110. The device according to any one of claims 99-109, wherein the opening comprises a deployed configuration for slidably receiving the functional unit in a subject’s body.

111. The device according to claim 110, wherein the deployed configuration is de / un-folded or dilated or enlarged or expanded or extended configuration.

112. The device according to any one of claims 110-111, wherein the opening is overcomeably biased toward the deployed configuration.

113. The device according to any one of claims 99-112, wherein the opening is an annular structure.

114. The device according to any one of claims 95-96, wherein the first assembling element comprises a first coupling surface, and the second assembling element comprises a second coupling surface, the first coupling surface and the second coupling surface being configured to couple together.

115. The device according to claim 114, wherein the first assembling element and the second assembling element are configured to removably couple together.

116. The device according to any one of claims 114-115, wherein the first coupling surface and the second coupling surface are configured to contact together.

117. The device according to claim 116, wherein the first coupling surface and the second coupling surface are configured to removably contact together.

118. The device according to any one of claims 114-117, wherein the first coupling surface and the second coupling surface are configured to engage together.

119. The device according to claim 118, wherein the first coupling surface and the second coupling surface are configured to removably engage together.

120. The device according to any one of claims 114-119, wherein the first coupling surface and the second coupling surface are configured to mate together.

121. The device according to claim 120, wherein the first coupling surface and the second coupling surface are configured to removably mate together.

122. The device according to any one of claims 114-121, wherein the first coupling surface and the second coupling surface are configured to abut together.

123. The device according to claim 122, wherein the first coupling surface and the second coupling surface are configured to removably abut together.

124. The device according to any one of claims 114-123, wherein the first coupling surface and the second coupling surface are configured for the functional unit to be immobilized relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker when the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker are assembled together in a subject’s body.

125. The device according to any one of claims 114-124, wherein the first coupling surface is magnetizable.

126. The device according to any one of claims 114-125, wherein the first coupling surface comprises a magnet configured to magnetically interact with the second coupling surface.

127. The device according to any one of claims 114-126, wherein the second coupling surface is magnetizable.

128. The device according to any one of claims 114-127, wherein the second coupling surface comprises a magnet configured to magnetically interact with the first coupling surface.

129. The device according to any one of claims 62-128, wherein the second implantable medical device component comprises an opening configured to slidably receive the elongated control member therethrough.

130. The device according to claim 129, wherein the opening is configured for the functional unit to slidably pass therethrough.

131. The device according to any one of claims 129-130, wherein the second implantable medical device component is configured to enclose at least partially the functional unit therein when the functional unit and at least one of the first implantable medical device component, the second implantable medical device component, and the linker are assembled together in a subject’s body.

132. The device according to any one of claims 62-131, wherein the second implantable medical device component is a docking unit, the docking unit and the functional unit being configured to dock together and undock from each other.

133. The device according to any one of claims 62-132, wherein the functional unit comprises a capturable element configured to be captured by a medical tool in a subject’s body.

134. The device according to claim 133, wherein the capturable element is a snareable element configured to be snared by a medical tool in a subject’s body.

135. The device according to any one of claims 133-134, wherein the capturable element projects from the first end portion of the functional unit.

136. The device according to claim 135, wherein the capturable element comprises a stem and a protrusion, the stem linking the protrusion to the first end portion of the functional unit.

137. The device according to claim 136, wherein the stem is resilient.

138. The device according to any one of claims 136-137, wherein the stem is flexible.

139. The device according to any one of claims 136-138, wherein the stem is bendable.

140. The device according to any one of claims 136-139, wherein the protrusion is magnetizable.

141. The device according to any one of claims 136-140, wherein the protrusion comprises a magnet.

142. The device according to any one of claims 58-141, wherein the second end portion of the first implantable medical device component is an atraumatic end portion configured to be atraumatically navigated in a subject’s body.

143. The device according to claim 142, further comprising: a guidewire configured to couple the atraumatic end portion.

144. The device according to claim 143, wherein the guidewire is configured to be navigated in a subject’s body.

145. The device according to any one of claims 65-144, wherein the atraumatic end portion is configured to be removable from the remainder of the first implantable medical device component for providing access to the second end portion of the elongated control structure when the elongated control structure is positioned through the first implantable medical device component.

146. The device according to any one of claims 142-145, wherein the atraumatic end portion has a tapered or profiled shape.

147. The device according to any one of claims 142-146, wherein the atraumatic end portion is a dilator tip.

148. The device according to any one of claims 58-147, wherein the functional unit is arranged substantially parallel relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker when the functional unit is assembled to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

149. The device according to any one of claims 58-148, wherein the functional unit is arranged substantially coaxially relative to at least one the first implantable medical device component, the second implantable medical device component, and the linker when the functional unit is assembled to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

150. The device according to any one of claims 58-149, wherein the functional unit is arranged substantially non-coaxially relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker when the functional unit is assembled to at least one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

151. The device according to any one of claims 58-150, wherein the functional unit is arranged substantially parallel relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker when the functional unit is sheathed and unassembled from at least one of the first implantable medical device component, the second implantable medical device component, and the linker.

152. The device according to any one of claims 58-151, wherein the functional unit is arranged substantially coaxially relative to at least one of the first implantable medical device component, the second implantable medical device component, and the linker when thefunctional unit is sheathed and unassembled from at least one of the first implantable medical device component, the second implantable medical device component, and the linker.

153. The device according to any one of claims 58-152, wherein the implantable medical device is sheathable for retrieval in a subject’s body when the functional unit is unassembled from at least one of the first implantable medical device component, the second implantable medical device component, and the linker.

154. The device according to any one of claims 58-153, further comprising: one or more of the assemblable medical device for a total of two or more of the assemblable medical devices, each functional unit of the two or more assemblable medical devices being configured to assemble to at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

155. The device according to claim 154, wherein each functional unit of the two or more of the assemblable medical devices is configured to unassemble from at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

156. The device according to any one of claims 154-155, wherein each functional unit of the two or more of the assemblable medical devices is configured to assemble simultaneously to at least a respective one of the medical device component, the second implantable medical device component, and the linker in a subject’s body.

157. The device according to any one of claims 154-156 wherein each functional unit of the two or more of the assemblable medical devices is configured to assemble consecutively one after the other to at least a respective one of first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

158. The device according to any one of claims 154-157, wherein each functional unit of the two or more of the assemblable medical devices is arranged substantially parallel relative to each other when each functional unit of the two or more of the assemblable medical devices is assembled to at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

159. The device according to any one of claims 154-158, wherein each functional unit of the two or more of the assemblable medical devices is arranged substantially non-coaxially relative to each other when each functional unit of the two or more of the assemblable medical devices is assembled to at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

160. The device according to any one of claims 154-159, wherein each functional unit of the two or more of the assemblable medical devices is arranged substantially transversally one next the other when each functional unit of the two or more of the assemblable medical devices is assembled to at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

161. The device according to any one of claims 154-160, wherein each functional unit of the two or more of the assemblable medical devices is configured to unassemble simultaneously from at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

162. The device according to any one of claims 154-161, wherein each functional unit of the two or more of the assemblable medical devices is configured to unassemble consecutively one after the other from at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker in a subject’s body.

163. The device according to any one of claims 154-162, wherein the implantable medical device is sheathable for delivery in a subject’s body when each functional unit of the two or more of the assemblable medical devices is unassembled from at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker.

164. The device according to claim 163, wherein each functional unit of the two or more of the assemblable medical devices is arranged substantially parallel relative to each other when each functional unit of the two or more of the assemblable medical devices is sheathed andunassembled from at least a respective one of the first implantable medical device component, the second implantable medical device component, and the linker.

165. The device according to any one of claims 163-164, wherein each functional unit of the two or more of the assemblable medical devices is arranged substantially longitudinally one after the other when each functional unit of the two or more of the assemblable medical devices is sheathed and unassembled from at least a respective one of the medical device component, the second implantable medical device component, and the linker.

166. The device according to any one of claims 1-165, wherein the medical device is transcatheterly implantable.

167. The device according to any one of claims 1-166, wherein the first implantable medical device component is one of a catheter and a canula.

168. The device according to any one of claims 1-167, wherein the second implantable medical device component is any one of a blood pump, a pacemaker, an implantable cardioverter defibrillator, an occluder, a left atrial appendage occluder, a heart valve, a valvuloplasty device, an annuloplasty device, an annuloplasty ring, a prosthetic valve chords, a stent, a stent-graft, an endovascular graft, a vascular closure device, an implantable hemodynamic monitoring devices, and / or a drug-eluting device.

169. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the blood pump to be electrically operated through the first implantable medical device component and the linker.

170. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the pacemaker to be electrically operated through the first implantable medical device component and the linker.

171. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the implantable cardioverter defibrillator to be electrically operated through the first implantable medical device component and the linker.

172. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the occluder to be electrically operated through the first implantable medical device component and the linker.

173. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the heart valve to be electrically operated through the first implantable medical device component and the linker.

174. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the implantable hemodynamic monitoring devices to be electrically operated through the first implantable medical device component and the linker.

175. The device according to claim 168, wherein the first implantable medical device component and the linker are configured for the drug-eluting device to be electrically operated through the first implantable medical device component and the linker.

176. The device according to any one of claims 62-175, wherein the functional unit of the assemblable medical device is any one of a blood pump, a pacemaker, an implantable cardioverter defibrillator, an occluder, a left atrial appendage occluder, a heart valve, a valvuloplasty device, an annul oplasty device, an annul oplasty ring, a prosthetic valve chords, a stent, a stent-graft, an endovascular graft, a vascular closure device, an implantable hemodynamic monitoring devices, and / or a drug-eluting device.

177. The device according to claim 176, wherein the elongated control structure is configured for the blood pump to be electrically operated through the first implantable medical device component and the linker.

178. The device according to claim 176, wherein the elongated control structure is configured for the pacemaker to be electrically operated through the first implantable medical device component and the linker.

179. The device according to claim 176, wherein the elongated control structure is configured for the implantable cardioverter defibrillator to be electrically operated through the first implantable medical device component and the linker.

180. The device according to claim 176, wherein the elongated control structure is configured for the occluder to be electrically operated through the first implantable medical device component and the linker.

181. The device according to claim 176, wherein the elongated control structure is configured for the heart valve to be electrically operated through the first implantable medical device component and the linker.

182. The device according to claim 176, wherein the elongated control structure is configured for the implantable hemodynamic monitoring devices to be electrically operated through the first implantable medical device component and the linker.

183. The device according to claim 176, wherein the elongated control structure is configured for the drug-eluting device to be electrically operated through the first implantable medical device component and the linker.

184. A method of implanting a medical device in a subject’s body, the medical device including a first implantable medical device component, a second implantable medical device component, and a linker linking the first implantable medical device component and the second implantable medical device component together, the method comprising:- implanting the medical device in the subject’s body to cause the linker to change the implantable medical device from a first arrangement to a second arrangement.

185. The method according to claim 184, wherein the first arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are linearly arranged relative to each other, and the second arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are non-linearly arranged relative to each other.

186. The method according to any one of claims 184-185, further comprising: introducing the first implantable medical device component through a first subject’s body access.

187. The method according to claim 186, wherein said introducing comprises introducing an atraumatic end portion of the first implantable medical device component through the first subject’s body access.

188. The method according to any one of claims 186-187, wherein said introducing comprises introducing the first implantable medical device component through the first subject’s body access before introducing the second implantable medical device component through the first subject’s body access.

189. The method according to any one of claims 186-188, wherein the first subject’s body access is a subject lower body access.

190. The method according to claim 189, wherein the first subj ect’s body access is one of a subj ect natural body access and a subject surgically made body access.

191. The method according to claim 189, wherein the first subject’s body access is a subject femoral access.

192. The method according to any one of claims 186-188, wherein the first subject’s body access is a subject upper body access.

193. The method according to claim 192, wherein the first subj ect’s body access is one of a subj ect natural body access and a subject surgically made body access.

194. The method according to claim 192, wherein the first subj ect’s body access is one of a subj ect axillary access and a subject subclavian access.

195. The method according to any one of claims 184-194, further comprising: navigating the first implantable medical device component up to a second subject’s body access.

196. The method according to claim 195, wherein said navigating comprises snaring the first implantable medical device component via a second subject’s body access.

197. The method according to any one of claims 195-196, wherein the second subject’s body access is a subject lower body access.

198. The method according to claim 197, wherein the second subject’s body access is one of a subject natural body access and a subject surgically made body access.

199. The method according to claim 197, wherein the second subject’s body access is a subject femoral access.

200. The method according to any one of claims 195-196, wherein the second subject’s body access is a subject upper body access.

201. The method according to claim 200, wherein the second subject’s body access is one of a subject natural body access and a subject surgically made body access.

202. The method according to claim 200, wherein the second subject’s body access is one of a subject axillary access and a subject subclavian access.

203. The method according to any one of claims 184-202, further comprising: externalizing at least partially the first implantable medical device component through the second subject’s body access.

204. The method according to any one of claims 184-203, further comprising: connecting the first implantable medical device component to a controller to operate the second implantable medical device component in the subject’s body through the first implantable medical device component.

205. The method according to claim 204, wherein said connecting the first medical device comprises connecting the first implantable medical device component outside the subject’s body.

206. The method according to any one of claims 184-205, further comprising: operating the second implantable medical device component in the subject’s body.

207. The method according to claim 206, wherein said operating the second implantable medical device component comprises operating the second implantable medical device component in the subject’s body through the first implantable medical device component and the linker.

208. The method according to any one of claims 206-207, wherein said operating the second implantable medical device component comprises operating the second implantable medical device component in the subject’s body from outside the subject’s body.

209. The method according to any one of claims 206-208, wherein said operating the second implantable medical device component comprises electrically operating the second medical device.

210. The method according to any one of claims 206-209, wherein said operating the second implantable medical device component comprises mechanically operating the second medical device.

211. The method according to any one of claims 184-210, further comprising: an assemblable medical device configured to assemble to the medical device in the subject’s body.

212. The method according to claim 211, further comprising: assembling the assemblable medical device and the medical device together in the subject’s body.

213. The method according to claim 212, wherein said assembling comprises assembling the assemblable medical device and the first implantable medical device component together in the subject’s body.

214. The method according to any one of claims 212-213, wherein said assembling comprises assembling the assemblable medical device and the second implantable medical device component together in the subject’s body.

215. The method according to any one of claims 212-214, wherein said assembling comprises assembling the assemblable medical device and the linker together in the subject’s body.

216. The method according to any one of claims 211-215, wherein the assemblable medical device comprises an elongated control structure.

217. The method according to claim 216, further comprising: actuating the elongated control structure for assembling the assemblable medical device and the medical device together in the subject’s body.

218. The method according to claim 217, wherein said actuating the elongated control structure comprises electrically actuating the elongated control structure.

219. The method according to any one of claims 217-218, wherein said actuating the elongated control structure comprises mechanically actuating the elongated control structure.

220. The method according to any one of claims 218-219, wherein said actuating is performed from outside the subject’s body.

221. The method according to any one of claims 216-220, further comprising: moving the elongated control structure relative to the medical device for assembling the assemblable medical device and the medical device together in the subject’s body.

222. The method according to claim 221, wherein said moving is performed from outside the subject’s body.

223. The method according to any one of claims 216-222, further comprising: manipulating the elongated control structure for assembling the assemblable medical device and the medical device together in the subject’s body.

224. The method according to claim 223, wherein said manipulating comprises pulling the elongated control structure.

225. The method according to any one of claims 223-224, wherein said manipulating is performed from outside the subject’s body.

226. The method according to any one of claims 216-225, further comprising: connecting the elongated control structure to a controller to operate the assemblable medical device in the subject’s body through the elongated control structure.

227. The method according to claim 226, wherein said connecting is performed outside the subject’s body.

228. The method according to any one of claims 216-227, further comprising: operating the assemblable medical device in the subject’s body.

229. The method according to claim 228, wherein said operating the assemblable medical device comprises operating the assemblable medical device in the subject’s body through the elongated control structure.

230. The method according to any one of claims 228-229, wherein said operating the assemblable medical device comprises operating the assemblable medical device in the subject’s body from outside the subject’s body.

231. The method according to any one of claims 228-230, wherein said operating comprises electrically operating the assemblable medical device.

232. The method according to any one of claims 228-231, wherein said operating comprises mechanically operating the assemblable medical device.

233. The method according to any one of claims 184-232, wherein the medical device is transcatheterly implantable in the subject’s body.

234. The method according to any one of claims 184-233, wherein the first implantable medical device component is configured to be navigable in the subject’s body.

235. The method according to any one of claims 184-234, wherein the first implantable medical device component has an elongated flexible body.

236. The method according to any one of claims 184-235, wherein the first implantable medical device component is one of a catheter and a canula.

237. The method according to any one of claims 184-236, wherein the second implantable medical device component is configured to be anchorable in the subject’s body, the method further comprising: anchoring the second medical device in the subject’s body.

238. The method according to claim 237, wherein said anchoring comprises anchoring the second implantable medical device component in a subject curved lumen.

239. The method according to any one of claims 237-238, wherein said anchoring comprises anchoring the second implantable medical device component in a subject curved blood vessel.

240. The method according to any one of claims 237-239, wherein said anchoring comprises anchoring the second implantable medical device component in any one of a subject aorta, carotid arteries, celiac trunk, mesenteric artery, coronary arteries, left atrium, right atrium, left ventricle, right ventricle, vena cava, innominate vein, hepatic veins, iliac veins, and portal vein, or trans-aortic, trans-mitral, trans-tricuspid, and trans-pulmonary.

241. The method according to any one of claims 237-240, wherein the second medical device is an anchor.

242. The device according to any one of claims 184-241, wherein the second implantable medical device component is any one of a blood pump, a pacemaker, an implantable cardioverter defibrillator, an occluder, a heart valve, an implantable hemodynamic monitoring devices, and / or a drug-eluting device.

243. The device according to any one of claims 184-241 , wherein the second implantable medical device component is any one of a left atrial appendage occluder, a valvuloplasty device, an annuloplasty device, an annuloplasty ring, a prosthetic valve chords, a stent, a stent-graft, an endovascular graft, and a vascular closure device.

244. Amethod of explanting a medical device from a subject’s body, the medical device including a first implantable medical device component, a second implantable medical device component, and a linker linking the first implantable medical device component and the second implantable medical device component together, the method comprising:- explanting the medical device from the subject’s body to cause the linker to change the implantable medical device from a first arrangement to a second arrangement.

245. The method according to claim 244, wherein the first arrangement is an arrangement in which the first implantable medical device component and the second implantable medical device component are linearly arranged relative to each other, and the second arrangementis a arrangement in which the first implantable medical device component and the second implantable medical device component are non-linearly arranged relative to each other.

246. The method according to any one of claims 244-245, further comprising: internalizing the first implantable medical device component through a first subject’s body access that receives the first implantable medical device component therethrough.

247. The method according to claim 246, wherein the first subject’s body access is a subject upper body access.

248. The method according to claim 247, wherein the first subject’s body access is one of a subject natural body access and a subject surgically made body access.

249. The method according to claim 247, wherein the first subj ect’s body access is one of a subj ect axillary access and a subject subclavian access.

250. The method according to any one of claims 246-249, wherein the first subject’s body access is a subject lower body access.

251. The method according to claim 250, wherein the first subj ect’s body access is one of a subject natural body access and a subject surgically made body access.

252. The method according to claim 250, wherein the first subject’s body access is one of a subject femoral access.

253. The method according to any one of claims 244-252, further comprising: navigating the second implantable medical device component up to a second subject’s body access.

254. The method according to claim 253, further comprising: sheathing at least partially the second implantable medical device component via the second subject’s body access to navigate the second medical device.

255. The method according to claim 253, further comprising: snaring the second implantable medical device component via the second subject’s body access to navigate the second medical device.

256. The method according to any one of claims 253-255, wherein the second subject’s body access is a subject lower body access.

257. The method according to claim 256, wherein the second subject’s body access is one of a subject natural body access and a subject surgically made body access.

258. The method according to claim 256, wherein the second subject’s body access is one of a subject femoral access.

259. The method according to any one of claims 253-255, wherein the second subject’s body access is a subject upper body access.

260. The method according to claim 259, wherein the second subject’s body access is one of a subject natural body access and a subject surgically made body access.

261. The method according to claim 259, wherein the second subject’s body access is one of a subject femoral access.

262. The method according to any one of claims 244-261, further comprising: withdrawing the second implantable medical device component through the second subject’s body access.

263. The method according to claim 262, wherein said withdrawing comprises withdrawing the second implantable medical device component through the second subject’s body access before withdrawing the first implantable medical device component through the second subject’s body access.

264. The method according to any one of claims 244-263, further comprising: stopping an operation of the second implantable medical device component operated in the subject’s body.

265. The method according to claim 264, wherein said stopping the operation of the second implantable medical device component comprises stopping the operation of the second implantable medical device component operated in the subject’s body through the first implantable medical device component and the linker.

266. The method according to any one of claims 264-265 wherein said stopping the operation of the second implantable medical device component comprises stopping the operation of the second implantable medical device component operated in the subject’s body from outside the subject’s body.

267. The method according to any one of claims 264-266, wherein said stopping the operation of the second implantable medical device component comprises stopping an electrical operation of the operation of the second implantable medical device component.

268. The method according to any one of claims 264-267, wherein said stopping the operation of the second implantable medical device component comprises stopping a mechanical operation of the operation of the second implantable medical device component269. The method according to any one of claims 244-268, further comprising: disconnecting the first implantable medical device component from a controller that operate the second implantable medical device component in the subject’s body through the first implantable medical device component.

270. The method according to claim 269, wherein said disconnecting the first medical device comprises disconnecting the first implantable medical device component outside the subject’s body.

271. The method according to any one of claims 244-270, further comprising: an assemblable medical device configured to assemble to the medical device in the subject’s body.

272. The method according to claim 271, further comprising: unassembling the assemblable medical device and the medical device from each other in the subject’s body.

273. The method according to claim 272, wherein said unassembling comprises unassembling the assemblable medical device and the first implantable medical device component from each other in the subject’s body.

274. The method according to any one of claims 272-273, wherein said unassembling comprises unassembling the assemblable medical device and the second implantable medical device component from each other in the subject’s body.

275. The method according to any one of claims 272-274, wherein said assembling comprises assembling the assemblable medical device and the linker from each other in the subject’s body.

276. The method according to any one of claims 271-275, wherein the assemblable medical device comprises an elongated control structure.

277. The method according to claim 276, further comprising: actuating the elongated control structure for unassembling the assemblable medical device and the medical device from each other in the subject’s body.

278. The method according to claim 277, wherein said actuating the elongated control structure comprises electrically actuating the elongated control structure.

279. The method according to any one of claims 277-278, wherein said actuating the elongated control structure comprises mechanically actuating the elongated control structure.

280. The method according to any one of claims 277-279, wherein said actuating is performed from outside the subject’s body.

281. The method according to any one of claims 277-280, further comprising: moving the elongated control structure relative to the medical device for unassembling the assemblable medical device and the medical device from each other in the subject’s body.

282. The method according to claim 281, wherein said moving is performed from outside the subject’s body.

283. The method according to any one of claims 276-282, further comprising: manipulating the elongated control structure for unassembling the assemblable medical device and the medical device from each other in the subject’s body.

284. The method according to claim 283, wherein said manipulating comprises pulling the elongated control structure.

285. The method according to any one of claims 283-284, wherein said manipulating is performed from outside the subject’s body.

286. The method according to any one of claims 276-285, further comprising: disconnecting the elongated control structure from a controller that operates the assemblable medical device in the subject’s body through the elongated control structure.

287. The method according to claim 286, wherein said disconnecting is performed outside the subject’s body.

288. The method according to any one of claims 276-287, further comprising: stopping an operation of the assemblable medical device operated in the subject’s body.

289. The method according to claim 288, wherein said stopping the operation of the assemblable medical device comprises stopping the operation of the assemblable medical device operated in the subject’s body through the elongated control structure.

290. The method according to any one of claims 288-289, wherein said stopping the operation of the assemblable medical device comprises stopping the operation of the assemblable medical device operated in the subject’s body from outside the subject’s body.

291. The method according to any one of claims 288-290, wherein said stopping the operation of the assemblable medical device comprises stopping an electrical operation of the operation of the assemblable medical device.

292. The method according to any one of claims 288-291, wherein said stopping the operation of the assemblable medical device comprises stopping a mechanical operation of the assemblable of the second medical device.

293. The method according to any one of claims 244-292, wherein the medical device is transcatheterly implantable in the subject’s body.

294. The method according to any one of claims 244-293, wherein the first implantable medical device component is configured to be navigable in the subject’s body.

295. The method according to any one of claims 244-294, wherein the first implantable medical device component has an elongated flexible body.

296. The method according to any one of claims 244-295, wherein the first implantable medical device component is one of a catheter and a canula.

297. The method according to any one of claims 244-296, wherein the second implantable medical device component is anchored in the subject’s body, the method further comprising: unanchoring the second medical device in the subject’s body.

298. The method according to claim 297, wherein said unanchoring comprises anchoring the second implantable medical device component in a subject curved lumen.

299. The method according to any one of claims 297-298, wherein said unanchoring comprises unanchoring the second implantable medical device component in a subject curved blood vessel.

300. The method according to any one of claims 297-299, wherein said unanchoring comprises unanchoring the second implantable medical device component in any one of a subject aorta, carotid arteries, celiac trunk, mesenteric artery, coronary arteries, left atrium, right atrium, left ventricle, right ventricle, vena cava, innominate vein, hepatic veins, iliac veins, and portal vein, or trans-aortic, trans-mitral, trans-tricuspid, and trans-pulmonary.

301. The method according to any one of claims 297-300, further comprising: sheathing the anchor to unanchor the anchor.

302. The method according to claim 301, wherein said sheathing comprises converting the anchor from an expanded configuration to a non-expanded configuration.

303. The device according to any one of claims 244-302, wherein the second implantable medical device component is any one of a blood pump, a pacemaker, an implantable cardioverter defibrillator, an occluder, a heart valve, an implantable hemodynamic monitoring devices, and / or a drug-eluting device.

304. The device according to any one of claims 244-302, wherein the second implantable medical device component is any one of a left atrial appendage occluder, a valvuloplasty device, an annuloplasty device, an annuloplasty ring, a prosthetic valve chords, a stent, a stent-graft, an endovascular graft, and a vascular closure device.

305. A medical snare instrument for capturing an implantable medical device, the medical snare instrument comprising:- a first elongated body;- a capture element associated with the first elongated body and configured to be converted between a non-capturing configuration and a capturing configuration, the capturing configuration being for capturing the implantable medical device; and- a second elongated body including a projecting end portion configured to project beyond the first elongated body, the projecting end portion including a terminal end portion, wherein at least one of the first elongated body and the terminal end portion is configured to be moved toward the other one of the first elongated body and the terminal end portion for converting the capture element between the non-capturing configuration and the capturing configuration.

306. The instrument according to claim 306, wherein the first elongated body is configured to be moved toward the terminal end portion for converting the capture element from the noncapturing configuration to the capturing configuration.

307. The instrument according to any one of claims 305-306, wherein the capture element and the terminal end portion are configured to be spaced apart from each other when the capture element is in the non-capturing configuration.

308. The instrument according to any one of claims 305-307, wherein the terminal end portion is configured to be located farther from the capture element when the capture element is in the non-capturing configuration than when the capture element is in the capturing configuration.

309. The instrument according to any one of claims 305-308, wherein the capture element is configured to be in a slidable relationship with the projecting end portion for converting the capture element between the non-capturing configuration and the capturing configuration.

310. The instrument according to any one of claims 305-309, wherein the capture element is configured to engage the terminal end portion for converting the capture element from the non-capturing configuration to the capturing configuration.

311. The instrument according to any one of claims 305-310, wherein the second elongated body is configured for the capture element to slide along a given length portion of the projecting end portion until the capture element engages the terminal end portion.

312. The instrument according to claim 311, wherein the given length portion is between 60 and 86 centimeters, inclusively.

313. The instrument according to any one of claims 305-312, wherein the first elongated body is configured to be moved away from the terminal end portion for converting the capture element from the capturing configuration to the non-capturing configuration.

314. The instrument according to any one of claims 305-313, wherein the capture element is configured to disengage from the terminal end portion for converting the capture element from the capturing configuration to the non-capturing configuration.

315. The instrument according to any one of claims 305-314, wherein the first elongated body is configured to at least partially receive the second elongated body therein.

316. The instrument according to any one of claims 305-315, wherein the projecting end portion of the second elongated body is configured for the terminal end portion thereof to be positioned along an outer peripheral portion of the first elongated body when the capture element is in the non-capturing configuration.

317. The instrument according to any one of claims 305-316, wherein the terminal end portion comprises a magnetizable element configured to magnetically interact with the implantable medical device for capturing the implantable medical device.

318. The instrument according to claim 317, wherein the magnetizable element is a permanent magnet.

319. The instrument according to claim 317, wherein the magnetizable element is an electromagnet configured to be operated through the second elongated body.

320. The instrument according to claim 317, wherein the magnetizable element is ferromagnetic.

321. The instrument according to any one of claims 305-320, wherein the capture element comprises a biasing element configured to bias the capture element toward the non-capturing configuration.

322. The instrument according to claim 321, wherein the biasing element comprises an unloaded configuration and a loaded configuration, the biasing element being in the unloaded configuration when the capture element is in the non-capturing configuration, the biasing element being in the loaded configuration when the capture element is in the capturing configuration.

323. The instrument according to any one of claims 321-322, wherein the biasing element is disposed inside the first elongated body.

324. The instrument according to any one of claims 305-323, wherein the capture element comprises a plurality of capture projections, each capture projection of the plurality of capture projections including a respective capture end portion 3018, the plurality of capture projections being convertible between the non-capturing configuration and the capturing configuration.

325. The instrument according to claim 324, wherein each capture projection of the plurality of capture projections is configured for the capture end portion 3018 to be positioned along an outer peripheral portion of the first elongated body when the capture element is in the noncapturing configuration.

326. The instrument according to any one of claims 324-325, wherein each capture projection of the plurality of capture projections comprises two arms that together forms an apex projecting from the capture element, the apex being the capture end portion 3018.

327. The instrument according to any one of claims 324-326, wherein the capture end portion 3018 comprises a protrusion.

328. The instrument according to any one of claims 324-326, wherein the capture end portion 3018 comprises ajaw.

329. The instrument according to any one of claims 305-328, further comprising: an operator handle including a control element configured to selectively control the conversion of the capture element between the non-capturing configuration and the capturing configuration.

330. The instrument according to claim 329, wherein the control element is configured to slide relative to the operator handle.

331. The instrument according to any one of claims 329-330, wherein the control element is configured to be coupled to the first elongated body for moving the first elongated body relative to the second elongated body.

332. The instrument according to any one of claims 329-331, further comprising: a locking mechanism configured to selectively lock the capture element in the capturing configuration.

333. The instrument according to claim 332, wherein the locking mechanism comprises the control element.

334. The instrument according to any one of claims 305-333, further comprising: a flush port configured to be in fluid communication with the first elongated body.

335. The instrument according to any one of claims 305-334, further comprising: a third elongated body configured to shield a movement of the first elongated body toward the terminal end portion therein from an outside environment.

336. The instrument according to claim 335, wherein the third elongated body is a sheath.

337. The instrument according to any one of claims 305-336, further comprising: a sheath loader configured to receive the first elongated body and the second elongated body therein.

338. The instrument according to any one of claims 305-337, wherein the first elongated body is a sheath.

339. The instrument according to any one of claims 305-338, wherein the second elongated body is a wire.

340. The instrument according to any one of claims 305-339, wherein the biasing element is one of a compression spring and a tension spring.

341. A method of using a medical snare instrument to capture a medical device implanted in a subject’s body, the medical snare instrument including a first instrument portion and a second instrument portion that projects beyond the first instrument portion, the method comprising:- establishing a magnetic interaction between the second instrument portion of the medical snare instrument and the medical device; and- moving at least one of the first instrument portion and the second instrument portion toward the other one of the first instrument portion and the second instrument portion to capture the medical device.

342. The method according to claim 341, wherein the second instrument portion comprises a magnetizable element that is positioned along an outer peripheral portion of the first instrument portion, wherein the method further comprising: rotating the medical snare instrument to establish the magnetic interaction.

343. The method according to claim 342, wherein said establishing comprises establishing a magnetic contact between the magnetizable element and the medical device.

344. The method according to any one of claims 341-343, wherein said moving comprises sliding the first instrument portion toward the second instrument portion to capture the medical device.

345. The method according to any one of claims 341-344, wherein said moving comprises sliding the first instrument portion along the second instrument portion until the first instrument portion engages the second instrument portion to capture to capture the medical device.

346. The method according to any one of claims 341-345, further comprising: sliding a control element of the medical snare instrument to move the first instrument portion toward the second instrument portion to capture the medical device.

347. The method according to claim 346, further comprising: locking the control element for the medical device to remain captured by the medical snare instrument.

348. The method according to any one of claims 341-343, wherein said moving comprises sliding the second instrument portion toward the first instrument portion to capture the medical device.

349. The method according to any one of claims 341-343 and 348, wherein said moving comprises sliding the second instrument portion along the first instrument portion until the second instrument portion engages the first instrument portion to capture the medical device.

350. The method according to any one of claims 341-343 and 348-349, further comprising: sliding a control element of the medical snare instrument to move the second instrument portion toward the first instrument portion to capture the medical device.

351. The method according to claim 350, further comprising: locking the control element for the medical device to remain captured by the medical snare instrument.

352. The method according to any one of claims 341-351, wherein the first instrument portion is associated with a plurality of capture projections having corresponding capture end portion 3018 peripherally located along an outer peripheral portion of the second instrument portion, wherein said moving causes the plurality of capture projections to relocate at least partially inside the second instrument portion.

353. The method according to any one of claims 341-352, wherein said establishing and said moving are performed by a single hand of an operator.

354. The method according to any one of claims 347 and 351, wherein said locking is performed by a single hand of an operator.

355. The method according to any one of claims 341-354, wherein the medical snare instrument captures the medical device implanted in a subject’s body, the method further comprising: retrieving the medical snare instrument from the subject’s body to explant the medical device implanted from the subject’s body.

356. The method according to claim 355, wherein said retrieving is pulling the medical snare instrument from the subject’s body.

357. The method according to any one of claims 355-356, wherein the medical snare instrument is retrieved through a lower body intracorporeal access of the subject’s body, and the medical device is explanted through the lower body intracorporeal access of the subject’s body.

358. The method according to any one of claims 355-357, wherein a body of the medical device is explanted first, followed by a driveline configured for the body to be operated therethrough.

359. The method according to any one of claims 341-358, wherein the medical device is a transcatheterly implantable blood pump.

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