Sealable and repositionable implant devices are provided to increase the ability of endovascular grafts and valves to be precisely deployed or re-deployed, with better in situ accommodation to the local anatomy of the targeted recipient anatomic site, and with the ability for post-deployment adjustment to accommodate anatomic changes that might compromise the efficacy of the implant. A surgical implant includes a self-expanding stent of a shape-memory material set to a given shape. The stent has a wall with a portion having a first thickness and a second portion having a thickness greater than the first. The second portion defines a key-hole shaped longitudinal drive orifice. The implant includes a selectively adjustable assembly having adjustable elements and being operable to force a configuration change in at least a portion of the self-expanding stent. The adjustable elements have a part rotatably disposed within the longitudinal drive orifice.

A selectively expanding spine cage has a minimized cross section in its unexpanded state that is smaller than the diameter of the neuroforamen through which it passes in the distracted spine. The cage conformably engages between the endplates of the adjacent vertebrae to effectively distract the anterior disc space, stabilize the motion segments and eliminate pathologic spine motion. Expanding selectively (anteriorly, along the vertical axis of the spine) rather than uniformly, the cage height increases and holds the vertebrae with fixation forces greater than adjacent bone and soft tissue failure forces in natural lordosis. Stability is thus achieved immediately, enabling patient function by eliminating painful motion. The cage shape intends to rest proximate to the anterior column cortices securing the desired spread and fixation, allowing for bone graft in, around, and through the implant for arthrodesis whereas for arthroplasty it fixes to endpoints but cushions the spine naturally.

A method for performing a surgical procedure on a patient using a robotic system and a navigation system. The robotic system includes a cutting tool. The navigation system has at least one locating device to track a portion of the patient during the surgical procedure. The navigation system provides information as to a position of the portion of the patient. An optical cutting guide is projected onto the portion of the patient to enable cutting of the portion of the patient with the cutting tool of the robotic system while the optical cutting guide is projected onto the portion of the patient.

Anchoring devices, anchoring systems for intervertebral implants, intervertebral implants, and instruments and methods for implanting implants are disclosed. In preferred configurations, these various objects share the feature of comprising or cooperating with an anchoring device having a body comprising at least one curved plate elongated along a longitudinal axis, designed to be inserted through a passage crossing at least a part of implant, in order to penetrate into at least one vertebral endplate and attach implant onto this vertebral endplate by means of at least one stop retaining the implant, characterized in that the body comprises at least one longitudinal rib on at least a part of at least one of its faces, said rib being designed to cooperate with a groove made in passage of implant. In some preferred configurations, anchoring device comprises withdrawal stops or latches, and/or means for withdrawing the anchor from an inserted position.

A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.

A prosthetic heart valve can include a support structure, an actuator member, and a plurality of leaflets. The support structure can have a plurality of struts and a plurality of rivets. The struts can have openings formed therein. The rivets can have first portions and second portions. The first portions can extend through the openings of the struts, and the second portions are larger than the first portion and the openings of the struts. The struts are pivotable about the rivets to radially expand and compress the support structure. The actuator member can be coupled to the struts of the support structure and configured to selectively actuate expansion and compression of the support structure. The leaflets can be coupled to the support structure and configured to allow unidirectional blood flow through the prosthetic heart valve.

A system and method of repairing a native chordae of a patient using an artificial chordae. The artificial chordae is inserted into the patient in a non-deployed configuration using a delivery system and is delivered to a desired position within the patient. An operator causes the artificial chordae to transition from the non-deployed configuration to a deployed configuration. The artificial chordae is anchored to a myocardium of the patient. The artificial chordae is attached to a leaflet of the native chordae at an attachment location and tuned to a desired tension.

An implant includes a first support, a second support rotatably coupled to the first support along a distal end of the implant, and a control assembly configured to move the implant between at least a first, collapsed orientation and a second, expanded orientation, the control assembly includes a control driver coupled to the first support and comprising a head and a shaft, the control driver configured to control relative movement between the first support and the second support, a control member configured to move along the shaft of the control driver, and a first linkage hingedly coupled to the control member and the second support, wherein movement of the control member causes the first support to move relative to the second support.

A placeholder for vertebrae or vertebral discs includes a tubular body, which along its jacket surface has a plurality of breakthroughs or openings for over-growth with adjacent tissue. The placeholder includes at least a second tubular body provided with a plurality of breakthroughs and openings at least partially inside the first tubular body. The first and second tubular bodies can have different cross-sectional shapes, can be are arranged inside one another by press fit or force fit or can be connected to each other via connecting pins and arranged side by side to one another in the first body.

Systems and methods for the manufacture of an hourglass shaped stent-graft assembly comprising an hourglass shaped stent, graft layers, and an assembly mandrel having an hourglass shaped mandrel portion. Hourglass shaped stent may have superelastic and self-expanding properties. Hourglass shaped stent may be encapsulated using hourglass shaped mandrel assembly coupled to a dilatation mandrel used for depositing graft layers upon hourglass shaped mandrel assembly. Hourglass shaped mandrel assembly may have removably coupled conical portions. The stent-graft assembly may be compressed and heated to form a monolithic layer of biocompatible material. Encapsulated hourglass shaped stents may be used to treat subjects suffering from heart failure by implanting the encapsulated stent securely in the atrial septum to allow blood flow from the left atrium to the right atrium when blood pressure in the left atrium exceeds that on the right atrium. The encapsulated stents may also be used to treat pulmonary hypertension.