A method for accessing a mitral valve that includes forming an incision and inserting a first catheter comprising a lumen. The first catheter is adapted to be directed towards a left atrium and the first catheter has a working length of approximately 15 cm to approximately 52 cm. The method further includes utilizing a trocar in the first catheter to penetrate a pericardium and utilizing the trocar to penetrate the left atrium. The method further includes accessing the mitral valve from an antegrade direction.

A steerable transseptal punch system and method of using the steerable transseptal punch system to access the left atrium.

Provided is an endoscope system including an elongated tube with one or more channels extending in a longitudinal direction along the elongated tube. The channels allow inserting of a viewing device for obtaining images from the distal end, inserting of surgical instruments to operate at the distal end, or passing of materials such as air or water. The channel for inserting the viewing device is enclosed or has a cover at the distal end of the elongated tube, such that the viewing device has no direct contact of body tissues, thereby eliminating the need for sterilization. Also provided is a safe and economical method for conducting endoscopy involving one-time use of a tube to keep the viewing device from directly contacting the body tissues.

Apparatus is described that includes a kit. The kit includes a flexible catheter (22) and a support (40). The catheter is transfemorally advanceable to a heart of a subject and the support is dimensioned for percutaneous access to the heart. The support has a proximal end, an elongate portion, and a distal portion (41) having a catheter-engaging element (38). The catheter-engaging element is configured to reversibly engage the catheter in a manner that does not inhibit longitudinal advancement of the catheter. Other embodiments are also described.

A medical device for injecting fat while simultaneously allowing the injection site to be viewed with ultrasound. The device may comprise a handle with a front portion and a rear portion, a cannula having a cannula tip, extending from the front portion of the handle, and an ultrasound probe attached to the handle, the ultrasound probe comprising an ultrasound head. The ultrasound head is aligned with and spaced apart from the cannula tip, and remains so aligned during the injection process so that the injection area may be continuously viewed during the procedure.

Systems, devices and methods for percutaneously modifying leaflets within the heart, thereby facilitating further repair or replacement. In some embodiments, the leaflets are cut. In other embodiments, the leaflets are removed either in part or in whole. The modifications to the leaflets may be made in conjunction with a prosthetic valve or independently.

The use of stepped cannulas, wherein a step structure creates a backstop to reduce backflow along the cannula body, is known for convection enhanced delivery of agents to the brain and other structures within an animal. Described herein are novel and improved stepped cannula designs wherein the length of the cannula segment between the step and the dispensing outlet is variable and can be controllably adjusted inside the patient during delivery. This advantageously allows the operator to place the cannula step at the optimal position and deliver agents at one or more positions within the target structure.

Improved methods and devices for performing an endoscopic surgery including a system for performing minimally invasive procedures including a flexible catheter having a working space expanding system positioned at a distal portion, the working space expanding system movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body lumen. A tissue retractor having an inner member positioned within an outer member has a plurality of closed loops at a distal portion forming a petal-like structure. The loops are positioned in a collapsed position within the outer member and are movable to an expanded position when exposed from the outer member.

A system and method for performing a non-fluoroscopic transseptal procedure may comprise a catheter and a device comprising a sheath, an introducer and a transducer embedded on the introducer and configured to perform a measurement during the non-fluoroscopic transseptal procedure. In this system, the transducer may be embedded on the outer surface of the introducer, or embedded on the inner surface of the introducer, or embedded within the introducer. The transducer may be a ring transducer or a circular transducer. The measurement is based on a plurality of ultrasonic pulses transmitted from the transducer, and the measurement determines a location of the catheter and/or a puncture location. In another embodiment, the transducer is embedded on a needle instead of an introducer.

A treatment method is disclosed capable of reducing the burden on a patient and enhancing the effect of killing tumor cells. The method includes administering an antibody-photosensitive substance into a vein; inserting an endoscope from a mouth, a nose, or an anus and bringing the endoscope to a vicinity of a tumor after the administering of the antibody-photosensitive substance into the vein; placing an optical fiber into the tumor or in the vicinity of the tumor; irradiating at least one of the tumor, the vicinity of the tumor, or a regional lymph node with a first near-infrared ray by the optical fiber; and irradiating the antibody-photosensitive substance bound to a tumor cell membrane in the tumor cell with a second near-infrared ray after the irradiating with the first near-infrared ray, the second near-infrared ray having a shorter wavelength than that of the first near-infrared ray.