Systems and methods for building a landing zone for an endovascular procedure are described. This procedure is “hybrid” in that it involves both direct access (e.g., sternotomy or partial sternotomy) to the site for installation of the landing zone, as well as endovascular installation of a TAVR or TEVAR device (e.g., stent graft) once the landing zone is installed. The landing zone is installed by wrapping a landing band around a portion of a vessel. The landing band may be selected to be fixed at a diameter so that it inhibits any expansion of the vessel, and also supports a later-installed TAVR or TEVAR device. The TAVR or TEVAR device is then endovascularly delivered to the vessel and deployed therein. The device expands until it contacts the vessel, which is supported from the outside by the landing band, which thus constrains and supports the device from outside.

Endovascular stents and endovascular device platforms and related methods that allow for the modulation/regulation of vascular flow to treat certain disease states are provided. In particular, a covered endovascular stent is provided that, upon deployment, is configured to an installed shape. A balloon catheter comprising a stem and an angioplasty balloon on an end of the stem can be provided to expand the stent. The angioplasty balloon can have a dumbbell shape when inflated with a first head on a first end of the angioplasty balloon having a first outer diameter and a second head on a second end of the angioplasty balloon having a second outer diameter and a narrow center portion having a third outer diameter that is less than the first outer diameter of the first end and the second outer diameter of the second end of the angioplasty balloon. Thereby, the covered stent configured in the installed shape can comprise a dumbbell shaped tubular structure having a first inner diameter of a first end portion and a second inner diameter of a second end portion that are larger than a third inner diameter within a center portion of the tubular structure.

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.

A heart valve includes a valve body made of a flexible material such as pericardium. The valve body is made of two layers of material, an outer layer, and an inner layer that defines a plurality of leaflets. The leaflets of the inner layer are attached to the outer layer. In some embodiments the valve body is made by cutting a single piece of flat source tissue, folding the cut tissue and forming it into a tubular pattern having the inner and outer layers. The multi-layer valve body can be mounted on a stent for delivery within a patient's heart.

A tubular prosthesis that includes a scaffolding formed by at least one scaffolding filament; a cover; and at least one controlled ingrowth feature constructed and arranged to abut an inner surface of a lumen wall when the prosthesis is implanted in the body lumen. The controlled ingrowth feature may extend inwards or outwards from the prosthesis outer surface. The controlled ingrowth feature may be formed by a scaffolding filament; by a separate filament; by the cover; and combinations thereof.

A tubular prosthesis that includes a scaffolding formed by at least one scaffolding filament; a cover; and at least one controlled ingrowth feature constructed and arranged to abut an inner surface of a lumen wall when the prosthesis is implanted in the body lumen. The controlled ingrowth feature may extend inwards or outwards from the prosthesis outer surface. The controlled ingrowth feature may be formed by a scaffolding filament; by a separate filament; by the cover; and combinations thereof.

A heart valve repair system includes a delivery sheath and an implant that includes a frame having a surface configured to contact an upstream surface of a native heart valve. First and second gripping members are coupled to the frame and each (1) includes first and second arms and (2) is configured to clamp a respective native leaflet. The implant is disposed in the sheath in a delivery state in which the frame defines a wall fully surrounding a central longitudinal axis of the implant. The distal end of the wall defines a distal opening of the frame. The distal end of the wall is disposed proximally to the entire first tissue-engaging surface of each of the gripping members and proximally to the entire second tissue-engaging surface of each of the gripping members. Other embodiments are also described.

A device includes a balloon and an interface. The balloon has an outer surface and a central lumen aligned on a longitudinal axis. The balloon is configured to receive a compressible fluid. The interface is coupled to the outer surface and has an external surface configured to bond with a tissue.

A device includes a balloon and an interface. The balloon has an outer surface and a central lumen aligned on a longitudinal axis. The balloon is configured to receive a compressible fluid. The interface is coupled to the outer surface and has an external surface configured to bond with a tissue.

A flow reducing implant for reducing blood flow in a blood vessel having a cross sectional dimension, the flow reducing implant comprising a hollow element adapted for placement in the blood vessel defining a flow passage therethrough, said flow passage comprising at least two sections, one with a larger diameter and one with a smaller diameter, wherein said smaller diameter is smaller than a cross section of the blood vessel. A plurality of tabs anchor, generally parallel to the blood vessel wall, are provided in some embodiments of the invention.