A shunt comprises a central flow portion configured to fit at least partially within an opening in a tissue wall. The tissue wall is situated between a first anatomical chamber and a second anatomical chamber and the opening represents a blood flow path between the first anatomical chamber and the second anatomical chamber. The central flow portion is further configured to maintain the blood flow path from the first anatomical chamber to the second anatomical chamber. The shunt further comprises a barrier configured to alter growth of tissue around the shunt.

Heart tissue electrical activity mapping used to guide the placement of devices to intervene in (treat) structural heart disease. In some embodiments, the intervention comprises placement of an implantable device, and/or positioning of a therapeutic device used to remove and/or remodel tissue. In some embodiments, electrical activity mapping is performed along with spatial mapping of a body cavity. In some embodiments, the intervention device position is compared to the measured positions of anatomical structures critical to heart electrical function to assess and/or prevent complications due to the device damaging heart electrical function.

An implantable closure device for sealing an opening, such as a puncture, through a biologic tissue membrane, such as the meninges, against leakage of biological fluid. The closure device includes a fluid sealing plug configured to be positioned at least partially within the opening through the biologic tissue membrane. A retainer is configured to secure the fluid sealing plug at least partially within the opening. The retainer includes a proximal retainer portion configured to be disposed proximally on the biologic tissue membrane, a distal retainer portion configured to be disposed distally on the biologic tissue membrane, and a central retainer portion connecting the proximal retainer portion and the distal retainer portion. The central retainer portion is configured to extend through the opening. The fluid sealing plug is coupled to the central retainer portion.

Disclosed herein is a tissue engaging surgical tool that is configured to selectively hold or grasp a portion of tissue with a suction cup or flexible end portion. The device is configured to increase or decrease pressure between the flexible end portion and tissue that the end portion is held against, thereby creating a releasable suction or vacuum force.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

A medical image-processing apparatus according to an embodiment includes processing circuitry configured to determine a position of a feature point of a device in a first X-ray image, and generate a superimposed image in which a 3D model expressing the device is superimposed on the first X-ray image or a second X-ray image that is acquired later than the first X-ray image. The processing circuitry is configured to superimpose the 3D model on the first X-ray image or the second X-ray image at a position based on the position of the feature point.

Provided herein are novel devices for the formation of arteriovenous fistulas, which may aid subjects in need of hemodialysis. The novel devices are provided in a non-surgical procedure, greatly decreasing the cost and increasing the convenience of placing an arteriovenous fistula. The devices are atraumatic, and consist of a sutureless anastomosis device and conduit. Methods and tools for placing the devices in vivo are disclosed, including a magnetic-assisted method.

The invention relates to a system for determining an optimal position of a surgical instrument relative to a patient's bone tracker, the system comprising:—a medical imaging system configured to acquire at least one cone beam computed tomography intraoperative image of the patient;—a localization device;—a computer configured to receive images from the medical imaging system and localization data from the localization device and to implement the following method: the method comprising: ⋅(a) receiving at least one preoperative 2D X-ray image of the bone while the patient is in a position of interest; ⋅(b) acquiring an intraoperative 3D medical image of the bone by cone beam computed tomography while the patient is in an operative position different from the position of interest, the 3D image being registered with the coordinate system of the bone tracker; ⋅(c) registering the intraoperative 3D medical image onto the at least one preoperative 2D X-ray image, so as to obtain a registered 3D image representing the bone in the position of interest; ⋅(d) planning a surgical procedure on the registered 3D medical image taking into account said position of interest; ⋅(e) determining an optimal position of the surgical instrument relative to the patient's bone tracker for implementing said planned surgical procedure.

The disclosed subject matter relates to a visual guide for aiding the surgeon in the insertion of a k-wire. The guide including a ring for receiving a guide wire, the guide wire extending from the ring parallel to the center axis of the ring; and, a ring attachment mechanism configured to attach the visual guide to a wire driver. The guide wires representing the trajectory of the k-wire in two orthogonal planes thus allowing the surgeon to free hand the insertion by visually referencing the guide wires and the actual trajectory of the k-wire within the bone.

A surgical device includes a first body component including at least one insert embedded therein and a second body component including a patient-specific surface. The first body component includes a first material and the at least one insert includes a second material. The first body component defines at least one first hole and the second body component defines at least one second hole. The second body component is configured to be coupled to the first body component such that the at least one first hole and the at least one second hole are aligned when the first body component is coupled to the second body component to define at least one continuous fixation hole sized and configured to receive an elongate fixation device at a predetermined location.