Occlusion effect reducing earplugs that have enhanced performance in reducing the occlusion effect are described. The occlusion effect reducing earplugs comprise a reservoir that form a region of high impedance mismatch with air. The reservoir can be a deep-seated reversible bi-stable reservoir that can be filled with a fluid. The occlusion effect reducing earplugs can also include a fitting plug that can serve to locate the balloon at depth and house one or more level-dependent filters, communication devices, and/or fluid filler bulbs.

An adjustable fixation device includes a cleat portion and a suture portion, where the suture portion has a loop portion and a suture tail. Pulling on the suture tail places in tension a graft coupled to the loop portion. The suture is arranged to convey a mechanical advantage so that substantial force can be readily and controllably applied to the graft.

At least a portion of sheet materials for use in medical devices is formed from polymeric materials. The sheet materials may be partially coated or fully coated with one or more additional layers of a polymer. The sheet materials may be used for the leaflets and/or cuffs of prosthetic heart valves and as a component of other medical devices.

Fixation device for fixation of leaflets of a heart valve includes an elongate central member defining a longitudinal axis of the fixation device and first and second arms rotatable about at least one arm hinge point between an open position and a closed position. The fixation device further includes a first gripping element rotatable about a first gripping element axis of rotation to capture a first leaflet of a heart valve between the first gripping element and the first arm. The fixation device further includes a second gripping element rotatable about a second gripping element axis of rotation to capture a second leaflet of a heart valve between the second gripping element and the second arm. At least one of the first gripping element axis of rotation and the second gripping element axis of rotation is variably offset from the arm hinge point by an axis offset distance defined along the longitudinal axis.

A mitral cerclage annuloplasty apparatus comprises a tissue protective device and a knot delivery device. The tissue protective device comprises a first protective tube and a second protective tube. The knot delivery device comprises a tube wherein a loose knot is looped around its distal end through a hole and wherein tight knot is formed when the distal end of the tube is cut open. Alternatively, the knot delivery device comprises an inner tube and outer tube. The inner tube is insertable and rotatable inside the outer tube. When the tubes are in a closed position by rotating either the outer tube or the inner tube, a hole is created near its distal end. When the tubes are in open position by rotating either the outer tube or the inner tube, the hole joins the opening of the outer tube and lengthens.

A method for controlling an artificial orthotic or prosthetic knee joint, on which a lower-leg component is arranged and with which a resistance device is associated, the bending resistance of which resistance device is changed in dependence on sensor data that are determined by at least one sensor during the use of the orthotic or prosthetic knee joint, wherein a linear acceleration of the lower-leg component is determined, the determined linear acceleration is compared with at least one threshold value, and, if a threshold value of the linear acceleration of the lower-leg component is reached, the bending resistance is changed.

An implant that includes a ring, anchors, and adjustment elements is advanced to a subject's heart valve. The ring includes hinges, and struts arranged in a pattern of alternating peaks and troughs. The ring circumscribes a central axis. At least one hinge is disposed at each trough. Each strut has a first end-portion and a second end-portion. Each peak is defined by convergence of adjacent first end-portions. Each trough is defined by convergence of adjacent second end-portions. Each anchor has a longitudinal axis. Within the heart, the longitudinal axis of at least one of the anchors is deflected with respect to the central axis, and each of the anchors is driven along its longitudinal axis with respect to the trough and into tissue of the heart. Subsequently, tissue of the heart is contracted by rotating the plurality of adjustment elements. Other embodiments are also described.

An annuloplasty device is disclosed comprising first and second support rings being configured to be arranged as a coil in a first configuration around an axial direction, wherein the first and second support rings are configured to be arranged on opposite sides of native heart valve leaflets of a heart valve, wherein the first and second support rings are separated with a first pitch distance in the axial direction, in the first configuration, wherein the first and second support rings are configured to assume a contracted state having a second pitch distance in the axial direction being shorter than the first pitch distance, and wherein the first and second support rings are configured to be transferable between the first configuration and the contracted state to pinch the heart valve leaflets. A method of repairing a defective heart valve is also disclosed.

An annuloplasty ring for repair of mitral valves whose shape can be altered remotely to perform post-implant size and/or shape adjustments. On version of the annuloplasty ring has a size-adjustable remodeling inner core within an outer suture-permeable interface for attaching the ring to an annulus. The inner core has an arcuate anterior segment that overlaps an arcuate posterior segment on opposite sides, with the segments being shaped in three dimensions to conform to the mitral annulus. The overlapping sides may have a ratchet mechanism with teeth on one engaging a detent on the other, or mating undulating bumps that can be adjusted in increments. A pair of adjustment filaments that pass through a delivery system and through channels in one segment may act on the other segment to adjust the peripheral shape of the annuloplasty ring.

A heart prosthesis system may include a prosthetic heart valve and a length of suture. The prosthetic heart valve may include a collapsible and expandable stent and a valve assembly mounted within the stent. The stent may have an aortic end, an annulus end, and a plurality of openings arranged circumferentially around the aortic end, the aortic end having a first diameter in an expanded condition. The length of suture may be threaded through the openings such that tension applied to the length of suture in a direction away from the stent may collapse the aortic end of the stent from the first diameter to a second diameter less than the first diameter.