A method of inserting and positioning an intervertebral spacer is provided. The spacer includes a longitudinal axis, an on-axis interface coincident with or parallel to the longitudinal axis, and an off-axis interface angled to the longitudinal axis. The spacer's front end may be curved. The method may include inserting the spacer into the disc space utilizing a tool to engage an on-axis interface and then to engage one or more of the off-axis interfaces, which may be used for further modification of the spacer. The tool is moved substantially along a single insertion direction, which may be substantially parallel to a posterior-anterior axis of the disc space. The method may result in the longitudinal axis of the spacer being perpendicular to the insertion direction, or substantially parallel to a medial-lateral axis of the disc space. The spacer may also be positioned in an anterior aspect of the disc space.

A system for implanting an inter-body device between adjacent vertebrae comprises an inter-body device having a plurality of cans secured to a flexible bridge and having a relief portion therebetween. An inserter tube and complementary bullnoses are advantageously secured to the vertebrae by an extension arm for securing the assembly precisely in place. A plurality of articulating trial implants are provided to test fit a disc space for the proper sized inter-body device.

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.

In some embodiments, a method includes delivering to a native valve annulus (e.g., a native mitral valve annulus) of a heart a prosthetic heart valve having a body expandable from a collapsed, delivery configuration to an expanded, deployed configuration. The method can further include, after the delivering, causing the prosthetic heart valve to move from the delivery configuration to the deployed configuration. With the prosthetic heart valve in its deployed configuration, an anchor can be delivered and secured to at least one of a fibrous trigone of the heart or an anterior native leaflet of the native valve. With the prosthetic heart valve disposed in the native valve annulus and in its deployed configuration, an anchoring tether can extending from the anchor can be secured to a wall of the heart to urge the anterior native leaflet towards the body of the prosthetic heart valve.

Provided are a stent graft and a stent-graft placement device with which it is possible to suitably align a side opening of a main blood vessel stent graft and a blood vessel opening of a branch blood vessel. The stent graft (10) is to be placed in a tubular tissue and is equipped with: a skeleton portion (11); a tubular graft portion (12) having, in part of a tube wall, a side opening (opening 121a of branch portion 121) that communicates with the lumen, the graft portion being provided along the skeleton portion; and a position adjustment portion (13) capable of adjusting the relative position of the side opening in the graft portion when the stent graft is placed in the tubular tissue.

An electronically assisted artificial vertebral disc having an upper disc plate and a lower disc plate is disclosed. An actuator imparts movement to at least one of the upper and lower disc plates. A control device controls the actuator and the amount of movement between the disc plates. The actuator includes a plurality of either linear actuators or rotary actuators that are driven by electric motors in response to the control device. The control device includes at least a first sensor for detecting the position of the actuator and at least a second sensor for detecting the spatial orientation of at least one of the upper and lower disc plates. The control device also preferably includes a microprocessor that calculates the desired positions of the upper and lower disc plates and provides a control signal to the actuator to drive the upper and lower disc plates to their desired positions.

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.

Methods, apparatuses and systems are described for delivering a stent through an access hole of a body lumen and covering up the access hole after deploying the stent, Stents are described that include a stent body defining a body lumen contact surface area and a deployable member configured to deploy from the stent body and increase the body lumen contact surface area of the stent. Deployable members that hinge, unroll, extend, expand, and coaxially translate with respect to the stent body are described. A system for delivering a stent into a body lumen are described that may include a coverage member configured to at least partially cover the hole in the wall of the stent upon withdrawing a tubular member through the hole in the wall of the stent. Coverage members may include a self-sealing membrane, a flap valve, or a hinged valve.

A spinal implant which is configured to be deployed between adjacent vertebral bodies. The implant has at least one fixation element with a retracted configuration to facilitate deployment of the implant and an extended configuration so as to engage a surface of an adjacent vertebral body and secure the implant between two vertebral bodies. Preferably, the implant is expandable and has a minimal dimension in its unexpanded state that is smaller than the dimensions of the neuroforamen through which it must pass to be deployed within the intervertebral space. Once within the space between vertebral bodies, the implant can be expanded so as to engage the endplates of the adjacent vertebrae to effectively distract the anterior disc space, stabilize the motion segments and eliminate pathologic spine motion. Angular deformities can be corrected, and natural curvatures restored and maintained.

An actuator sleeve includes resiliency features that may reduce chronic strain on valve annulus implants. The resiliency features may relate to one or more of a material, a manufacture, a dimension, and/or design attribute of the sleeve. In one aspect the resiliency features may allow deformation of the sleeve at frame interfaces to distribute forces to reduce the frame fatigue.