A surgical instrument includes a housing, an end effector assembly, and a shaft. The end effector assembly includes first and second jaw members each defining a curved configuration. At least one of the jaw members is movable relative to the other between a spaced-apart position and an approximated position. The shaft includes a proximal portion coupled with and extending distally from the housing and a distal portion extending distally from the proximal portion and having the end effector assembly coupled thereto at the distal end thereof. The proximal portion defines a circular cross-sectional configuration to facilitate formation of a fluid-tight seal thereabout. The distal portion defines a rectangular cross-sectional configuration configured to facilitate insertion through a cannula.

A catheter member for interacting with a circumferential tissue structure includes: an elongate primary catheter having at least one inner lumen and extending along a longitudinal axis; first and second elongate secondary catheters, each having an inner lumen, and each positionable in an inner lumen of the primary catheter to be moveable relatively thereto and exposable therefrom; and a first flexing mechanism to provide a distal end portion of the first and/or second secondary catheter with a tendency to assume a first secondary bent shape. The distal end portion of the first and/or second secondary catheters is provided so as to be able to be flexed by the first flexing mechanism to form an arm portion substantially transverse to the direction of the longitudinal axis of the primary catheter so as to assume the first secondary bent shape when exposed from a distal end portion of the primary catheter.

A method for carrying out a cardiac procedure includes: a. via an inferior artery, advancing a perforating tip of a perforation device towards an aorta; b. positioning the perforating tip adjacent a wall of the aorta, proximate a left pulmonary artery; and c. advancing the perforating tip to perforate through the wall of the aorta and then through a wall of the left pulmonary artery, to create a pathway between the aorta and the left pulmonary artery.

A method for carrying out a cardiac procedure includes a. via a superior artery, advancing a perforating tip of a perforation device towards an aorta; b. positioning the perforating tip adjacent a wall of the aorta, proximate a left pulmonary artery; and c. advancing the perforating tip to perforate through the wall of the aorta and then through a wall of the left pulmonary artery, to create a pathway between the aorta and the left pulmonary artery.

A method for carrying out a cardiac procedure includes: a. via an inferior artery, advancing a perforating tip of a perforation device towards an aorta; b. positioning the perforating tip adjacent a wall of the aorta, proximate a left pulmonary artery; and c. advancing the perforating tip to perforate through the wall of the aorta and then through a wall of the left pulmonary artery, to create a pathway between the aorta and the left pulmonary artery.

An asymmetric occlusion device for occluding an opening in a body tissue where part of the opening is defined by a partial inadequate rim. The asymmetric occlusion device includes a waist portion having a distal end extending to a proximal end. The waist portion is of non-woven material extending around a longitudinal axis opening. The occlusion device further includes a pair of asymmetric occluder disks attached to the waist. The asymmetric distal and proximal occluder disks are formed of shape memory material. The asymmetric occluder disks include a short arm extending from the waist and an extended arm extending from the waist. The extended arm exceeds the length of the first short arm. The density of the first short arm exceeds the density of the second extended arm.

An apparatus (100) includes: a expandable structure (140) formable into three dimensional shapes including a range of diameters (D) and corresponding lengths (L); a movable component (106) moveable between a range of positions (124, 126) effecting the range of diameters; and a mechanical linkage (110) disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel (204) of an endoscope (202) when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location (400) past a distal end (404) of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

Systems, methods and devices for performing an endoscopic procedure are provided herein, including an endoscopic plug designed to create a sealed environment within a body cavity using an internal expandable portion which maintains a collapsed configuration during an insertion process or removal process, but which can be expanded upon insertion into the body cavity to secure an internal portion of the endoscopic plug within the body cavity while creating a seal to prevent leakage of gas or fluid out of the body cavity during the endoscopic procedure.

An apparatus for explanting an intracardiac medical device that comprises a casing, a proximal end and a distal end comprising an anchor element, wherein the intracardiac medical device is anchored to a heart tissue of a patient via the anchor element, wherein heart tissue adheres to the casing. The apparatus comprises a protector device that extends along an extension direction and is configured to surround the casing, when the protector device is positioned at the casing. Further, the apparatus comprises an alignment device configured to align the protector device and the casing with each other, when the alignment device engages the intracardiac medical device. The apparatus also comprises a shearing element. The shearing element is configured to move along the casing, when the protector device is moved along the casing in a moving direction towards the distal end, for shearing off heart tissue adhered to the casing.

Various aspects of the present disclosure are directed toward apparatuses, systems and methods that include arranging an acute alteration of blood flow in, for example, heart failure patients.