Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may comprise a simple helical coil or interlocking helical channels, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Liquid inflation fluid may be directed so as to pressurize the balloons from an inflation fluid canister, and may vaporize within a plenum or the channels or balloons of the articulation system, with the inflation system preferably including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems, and also for industrial robotics, for supporting imaging systems, for entertainment and consumer products, and the like.

A device (30) for fracturing calcifications in heart valves includes a first heart valve treatment member (12) that extends from a first shaft (20) and which includes a scoring portion (16). A second heart valve treatment member (32) extends from a second shaft (36) and has a counterforce member (34). The second heart valve treatment member (32) and counterforce member (34) are coupled to the second shaft (36) with a brace (35) arranged to bear a force applied by scoring portion (16) to the counterforce member (34).

Devices, systems and methods are provided for stabilizing and grasping tissues such as valve leaflets, assessing the grasp of these tissues, approximating and fixating the tissues, and assessing the fixation of the tissues to treat cardiac valve regurgitation, particularly mitral valve regurgitation.

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device includes three balloons that are each sized and shaped to fit within a concave portion of a valve cusp when inflated with a liquid and a shock wave source within each of the three balloons. Each balloon is separately and/or independently inflatable, and each shock wave source is separately and/or independently controllable. Methods of treating calcified heart valves using a shock wave device can include advancing a shock wave device having one or more balloons and a shock wave source in each of the balloons to contact a heart valve, inflating the one or more balloons with a liquid such that the balloon is seated within a concave portion of a valve cusp, and activating the shock wave source.

A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves. The shock waves propagate through the liquid and impinge upon the valve to decalcify and open the valve.

A balloon aortic lithotripsy assembly for placement adjacent an aortic valve. The balloon aortic lithotripsy assembly includes multiple balloon chambers, a shell, and a shock wave generator. The balloon chambers are arranged to establish an open interior residing inboard of the balloon chambers. The shell is located around the balloon chambers. The shock wave generator can be situated on one or more of the balloon chambers, the shell, or both of the balloon chamber(s) and shell. In use, blood is free to travel through the open interior, and the shock wave generator can produce shock waves that are intended to impinge calcified tissues residing at the aortic valve.

An apparatus includes a balloon adapted to be placed adjacent a calcified region of a body. The balloon is inflatable with a liquid. The apparatus further includes a shock wave generator within the balloon that produces shock waves that propagate through the liquid for impinging upon the calcified region adjacent the balloon. The shock wave generator includes a plurality of shock wave sources distributed within the balloon.

An invasive electrohydraulic lithotripter probe may comprise a lithotripter tip that comprises a first electrode and a second electrode. The lithotripter tip has a length in excess of 250 cm and is dimensioned to be inserted into a long channel having a length in excess of 250 cm. The lithotripter probe may include a material that reinforces a linear strength of at least a portion of the lithotripter probe.

The invention provides a device for generating shock waves. The device may comprise an elongated tube and a conductive sheath circumferentially mounted around the elongated tube. The device may further comprise first and second insulated wires extending along the outer surface of the elongated tube. A portion of the first insulated wire is removed to form a first inner electrode, which is adjacent to a first side edge of the conductive sheath. A portion of the second insulated wire is removed to form a second inner electrode, which is adjacent to a second side edge of the conductive sheath. Responsive to a high voltage being applied across the first inner electrode and the second inner electrode, a first shock wave is created across the first side edge and the first inner electrode, and a second shock wave is created across the second side edge and the second inner electrode.

A method for heart valve treatment includes providing a first heart valve treatment member movable along a first shaft portion, providing a second heart valve treatment member movable along a second shaft portion. The first and second heart valve treatment members are movable along the first and second shaft portions, respectively. The first heart valve treatment member is positioned on one side of a heart valve leaflet and the second heart valve treatment member is positioned on an opposite side of the heart valve leaflet. A portion of the heart valve leaflet is fracture by movement of the first heart valve treatment member with respect to the second heart valve treatment member.