Some embodiments an implant supports female genitlia, for example, to treat and/or prevent prolapse and/or urinary incontinence. The implant may be inserted into a vagina non-surgically. Optionally, the device may be incorporated within the vaginal wall. Optionally, the device includes a hollow elastic frame. For example, the frame may be made of metal and/or wire and/or a cut out and/or a polymer. In some embodiment a cranial portion of the device is designed for supporting the vaginal dome. For example, the cranial end of the device may include an element (e.g., support wires) running in an anterior-posterior direction. Optionally there may be a free space avoiding interference with the uterine cervix. In some embodiments, a caudal portion of the device is configured to hold the device in the vagina. For example, a caudal end of the device may be configured to rest on the pelvic floor

The present invention provides a bileaflet heart valve that has a central flow hemodynamic configuration similar to the human aortic valve. Further, the present invention provides a bileaflet heart valve that successfully removes the incidence of thrombosis. This design minimizes the mechanical resistance against leaflet movement and allows for a greater washing effect to minimize thrombosis.

An annuloplasty band and method of implantation. The band is shaped and sized to avoid the adjacent aortic valve structure and better protects against dehiscence along the muscular mitral annulus. The band is asymmetric and when implanted spans more around the side of the mitral annulus having the posterior commissure than the side with the anterior commissure. The band has a saddle shape with a posterior upward bow centered on a minor axis of the mitral annulus, and a span extending clockwise therefrom is longer than a span extending counter-clockwise. A set of rings may have different saddle profiles and different plan view shapes for different sized bands. A method includes implanting so that the band extends over the posterior leaflet and a short distance past the posterior commissure outside of the anterior leaflet.

A prosthesis suited for orthopedic implantation possesses a multi-piece stem component that supports an artificial joint surface that can articulate with another artificial joint surface in various ways. The prosthesis can be assembled in a snap fit and/or interlocking fashion that provides positive locking means without the use of screws or other fasteners. The prosthesis can accommodate fitment of a plastic joint surface made, e.g., from ultra high molecular weight polyethylene. The prosthesis is well suited for use in an ankle replacement system that can be installed using minimally invasive intramedullary guidance established with respect to the major axis of the tibia by minimally invasive access through the calcaneus, through an incision in the bottom of the foot. The prosthesis makes possible the installation of a total ankle system using minimally invasive anterior access to the ankle joint for making bony cuts and to install prosthesis components.

A mitral valve prosthesis is percutaneously and/or transapically deployed in at least two stages. In a first stage, a mitral annular ring platform adapted for percutaneous delivery is delivered to and anchored in the mitral valve annulus. In the second stage, a valved-stent mitral valve prosthetic device adapted for percutaneously delivery is delivered to the mitral valve annulus for mounting in the mitral annular ring platform. This approach provides a consistent platform for accepting valved-stent mitral valve prosthetic devices from different vendors to be used.

There is disclosed a porous emboli deflector for preventing cerebral emboli while maintaining cerebral blood flow during an endovascular or open surgical procedure. The device prevents the entrance of emboli of a size able to cause stroke (such as greater than 100 microns) from entering either the right or left common carotid arteries, and/or the right or left vertebral arteries by deflecting emboli downstream of these vessels. The device can be placed prior to any manipulation of the heart or aorta allowing maximal protection of the brain during the index procedure. The deflector has a low profile within the aorta which allows sheaths, catheters, or wires used in the index procedure to pass. Also disclosed are methods for insertion and removal of the deflector.

A collapsible device, such as an annuloplasty ring or prosthetic heart valve, is configured to be collapsed prior to being introduced into a patient via minimally-invasive access points such as port holes or intercostal incisions. A holder is configured to hold the collapsible device, and to selectively collapse the device for introduction into the patient and then re-enlarge the device at the desired deployment site. Collapsible devices include devices that can hingedly fold about hinge lines, and devices that can elongate to form substantially spiral forms with reduced diameters.

A stent graft prosthesis for repair of a defective natural vessel comprises a tubular fabric member having at least first and second ends, wherein at least one of those ends is supported by a combination of two cooperating ring stents of different configurations, and the tubular fabric member is attached at selected points to each ring stent, and at least one ring stent is compressible into a folded saddle shape having two peaks and two valleys, and the other ring stent crosses over the saddle shape ring stent at four points, each point being in a region between a peak and a valley of the folded saddle shape. The other ring stent may be selected from ring stents which when deployed, have a circular or cylindrical shape, or a saddle shape, or one or more V-shaped hinge portions with curvilinear portions therebetween, or a Z-shaped stent.

A heart valve prosthesis is provided that includes a first member and a second member. The first member comprises a first central portion to be disposed adjacent to a line of coaptation on a first side of two adjacent heart leaflets and peripheral portions to be placed into direct contact with the two adjacent heart leaflets. The second member is separate from or can be separable from the first member, for example during delivery. The second member has a central portion and peripheral portions configured to be placed into direct contact with a second side of the two adjacent heart leaflets.

Disclosed are methods and devices for isolating all three of the left subclavian, left common carotid and brachiocephalic arteries from embolic debris that might flow through the aortic arch, via a single access point. A system may include an elongate flexible tubular sheath, having a proximal end and a distal end, and an inner member extending through the sheath and moveable relative to the sheath. A left subclavian element may be supported by the inner member. A filter membrane may be configured to isolate the aorta from the brachiocephalic, left common carotid and left subclavian arteries when the left subclavian element is expanded within the left subclavian artery and the sheath is retracted to expose the membrane. The left subclavian element may include a self expandable frame, which may carry a left subclavian filter.