A device for closing a tissue opening includes a proximal housing portion having a first portion, a second portion, a third portion, and a fourth portion. The first portion and the fourth portion extending transversely to a longitudinal axis of the proximal housing portion on opposite sides of the proximal housing portion. A distal portion extends from the proximal housing portion. At least the second portion and the third portion are configured to move toward the first portion.

A closure system configured to facilitate hemostasis at a puncture of a vessel includes a delivery sheath that extends longitudinally from a proximal end to a distal end. The delivery sheath defines a lumen extending therethrough. The delivery sheath lumen is configured to receive a first guidewire therethrough. The system also includes an introducer needle coupled to the delivery sheath at an offset relative to the delivery sheath. The introducer needle defines a lumen extending therethrough. The introducer needle lumen is configured to receive a second guidewire therethrough.

A closure system configured to facilitate hemostasis at a puncture of a vessel includes a delivery sheath that extends longitudinally from a delivery sheath proximal end to a delivery sheath distal end. The delivery sheath defines a delivery sheath lumen extending therethrough and configured to receive a first guidewire therethrough. The system also includes an introducer needle configured to selectively couple to the delivery sheath for movement relative to the delivery sheath. The introducer needle is configured to form a secondary access site in the vessel at an offset from the puncture after the delivery sheath distal end is advanced through the puncture. The system further includes a stylet configured to be received through the delivery sheath lumen adjacent to the first guidewire. The stylet includes a stylet magnet configured to magnetically couple to a guidewire magnet of a second guidewire advanced through the secondary access site.

A closure system and methods of use are provided for use in sealing an opening in a body tissue, such as a vascular puncture site. A method of closing the opening in the body tissue can be performed with the closure system having a closure clip. The method can include positioning the closure clip in a first closure clip position adjacent to the opening in the body tissue such that a plurality of spikes of the closure clip are inserted into the tissue at a location outward from a central axis of the opening. Subsequently, the closure clip can be positioned in a second closure clip position such that the plurality of spikes are pulled inward toward the central axis of the opening so as to pull the tissue between the opening and each of the spikes together and close the opening.

A method for delivering a closure element to an opening formed in a wall of a body lumen. The method includes inserting a distal end region of an apparatus into the opening in the wall of the body lumen, moving a third grasping portion toward the first grasping portion to limit movement of the distal end of the apparatus relative to the opening in the wall of the body lumen, and moving a second grasping portion toward the first grasping portion to advance the closure element distally. The second grasping portion and third grasping portion are movable toward the first grasping portion.

A hemostatic device for sealing a puncture of a vessel includes a first tube defining a first lumen, and a malecot coupled to the first tube. The malecot is selectively actuatable from a neutral configuration to a stopper configuration. The hemostatic device also includes a second tube circumscribing at least a portion of the first tube. The second tube at least partially defines a second lumen and a third lumen. The second tube includes a first opening in flow communication with the third lumen and positioned proximally relative to the malecot. The second tube is selectively orientable to at least partially expose a hemocoagulant agent retained in the second lumen.

A system includes an introducer configured to be inserted through the puncture along a guidewire that extends through the puncture into the vessel. The introducer includes an introducer body, a proximal tapered tip, a distal tapered tip that is opposite to the proximal tapered tip along the central axis, and a bore that extends from the proximal tapered tip to the distal tapered tip along the central axis. The system includes an access sheath configured to be inserted over the introducer. The access sheath includes a front end, a rear end opposite to the front end, and a lumen that extends from the front end to the rear end. The proximal tapered tip of the introducer is configured to be inserted into the front end and through the lumen of access sheath, such that a movable interference fit is attained between the access sheath and the introducer.

Systems, devices, and methods for providing access to the heart. The system includes an intracardiac access device comprising an elongate member having a channel extending between a distal end and a proximal end thereof. The intracardiac access device is configured to be advanced through an extrapericardial penetration in the left atrial wall without penetrating the pericardium of the heart. An optional procedural device is configured to be advanced through the channel of the intracardiac access device into an internal chamber of the heart and configured to perform a surgical procedure in the internal chamber of the heart. A working channel of an optional suprasternal access device is configured to facilitate access of the intracardiac access device into the body of the patient by providing a path from a suprasternal opening to a position adjacent the roof of the left atrium.

A hemostatic device for sealing a puncture of a vessel includes a first tube defining a first lumen. The first lumen is configured to receive a guidewire and a flow of a fluid therethrough. The hemostatic device also includes a second tube circumscribing at least a portion of the first tube and at least partially defining a second lumen. The hemostatic device further includes a substantially rigid stopper coupled to a distal end of the second tube. The stopper defines a stopper lumen that receives the first tube therethrough in an interference fit. A first opening is defined in a side wall of the first tube and positioned distally relative to the stopper. At least one injection groove defined in an outer surface of the stopper cooperates with the distal end of the second tube to define at least one second opening in flow communication with the second lumen.

Methods and apparatus are provided for fastening or clamping tissue to tissue or non-tissue layers and for occluding tubular body structures.