Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include an access sheath including an elongate body with an internal lumen to facilitate delivery of a device to a target location within a patient. The elongate body may include a distal portion having a distal opening and a plurality of curved segments configured to orient the distal opening relative to the target location.

A system for deploying a prosthesis over a Carina between an ipsilateral lumen and a contralateral lumen includes a guidewire, a guidewire capture catheter, a self-expanding tubular prosthesis, and a delivery catheter. The guidewire is first placed in the ipsilateral lumen. The guidewire capture catheter is then advanced from the contralateral lumen to a position at or above the ipsilateral lumen. The guidewire is typically advanced through an occlusion, which may be a total occlusion, and captured by a capture element on the guidewire capture catheter. The guidewire capture catheter pulls the guidewire out through the contralateral side, and the guidewire is used to advance a delivery catheter from the ipsilateral side. The delivery catheter delivers a first segment of the tubular prosthesis in the ipsilateral lumen and a second segment of the prosthesis in the contralateral lumen.

A method for delivering a therapeutic device to a target aortic valve site includes transseptally positioning a cable to run between a femoral artery, through the heart via an aortic valve, left ventricle, mitral valve, left atrium, and right atrium into the venous vasculature, the flexible member having a first end extending outside the body from a venous vessel superior to the heart and a second end external to the patient at the femoral artery. The aortic valve therapeutic device is attached to the cable outside the body and introduced into a femoral artery. A steerable sheath is advanced over the cable, into the venous vasculature and into the left ventricle of the heart. The aortic valve therapeutic device is pushed in a distal direction from the femoral artery while the cable is pulled from the venous vessel to advance the aortic valve therapeutic device to the target site. The sheath protects surrounding tissues from the cable during movement of the therapeutic device through the vasculature, and may be steered during final positioning to align the aortic valve therapeutic device at the target site.

A circulation assist system measures impeller displacement for use in estimating a blood flow rate related parameter. A circulation assist system includes a blood pump and a controller. The blood pump includes an impeller magnetically supported within a blood flow channel. The blood pump includes one or more sensors configured to generate output indicative of displacement of the impeller along the blood flow channel induced by a blood-flow induced thrust load applied to the impeller. The controller is configured to process the output generated by the one or more sensors to determine the displacement of the impeller along the blood flow channel. The controller is configured to process the determined displacement of the impeller to estimate at least one of the thrust load applied to the impeller, a pressure differential of the blood impelled through the blood flow channel, and a flow rate of blood pumped by the blood pump.

The systems, devices, and methods presented herein use a blood pump to obtain measurements of cardiac function. The system can quantify the functioning of the native heart by measuring certain parameters/signals such as aortic pressure or motor current, then calculate and display one or more cardiac parameters and heart function parameters, such as left ventricular pressure, left ventricular end diastolic pressure, or cardiac power output. These parameters provide valuable information to a user regarding current cardiac function, as well as positioning and function of the blood pump. In some embodiments, the system can act as a diagnostic and therapeutic tool. Providing cardiac parameters in real-time, along with warnings about adverse effects and recommendations to support cardiac function, such as increasing or decreasing the volumetric flow rate of blood pumped by the device, administering pharmaceutical therapies, and/or repositioning the blood pump allow clinicians to better support and treat cardiovascular disease.

A catheter body of a guiding catheter configured to be introduced into the renal artery, the catheter body including a plurality of abutting portions abutting at least two sites of the inner wall of the aorta on the abdominal side relative to the heart when the distal portion is disposed in the renal artery. A method for using a guiding catheter for the renal artery including providing the guiding catheter for the renal artery; inserting the guiding catheter from an artery in the arm and disposing a distal portion of the guiding catheter in the renal artery via the aorta; and causing the plurality of abutting portions to abut the inner wall of sections further on the abdominal side than the heart, in the aorta.

An implantable pump includes a rigid housing with an oblate spheroid shape and having an inner chamber divided by a movable elastomeric membrane into a gas sub-chamber which is connectible through a drive line to an external pneumatic source, and a blood sub-chamber which is connectible through a graft assembly to an anatomical heart. The housing includes a blood port opening oriented at an angle and at the upper apex of the housing and connected to the blood sub-chamber, and a gas port opening to the gas sub-chamber that is situated at a lower apex of the housing. The pump is provided with a drive line that includes a gas conduit and a heart sensor, the drive line connectible to a drive system that is capable of delivering gas flow through the drive line gas conduit in response to signals driven by the heart sensor.

A pressure differential across a blood pump and/or a flow rate of blood pumped by the blood pump is estimated based at least in part on impeller thrust load. A blood pump for a circulation assist system includes a housing forming a blood flow channel, an impeller, one or more support members coupled to the housing, a sensor, and a controller operatively coupled with the sensor. At least one of the one or more support members react a thrust load applied to the impeller by blood impelled through the blood flow channel by the impeller. The sensor generates output indicative of the magnitude of the thrust load. The controller is configured to process the sensor output to estimate at least one of a pressure differential across the blood pump and a flow rate of blood pumped by the blood pump.

A system for deploying a prosthesis over a Carina between an ipsilateral lumen and a contralateral lumen includes a guidewire, a guidewire capture catheter, a self-expanding tubular prosthesis, and a delivery catheter. The guidewire is first placed in the ipsilateral lumen. The guidewire capture catheter is then advanced from the contralateral lumen to a position at or above the ipsilateral lumen. The guidewire is typically advanced through an occlusion, which may be a total occlusion, and captured by a capture element on the guidewire capture catheter. The guidewire capture catheter pulls the guidewire out through the contralateral side, and the guidewire is used to advance a delivery catheter from the ipsilateral side. The delivery catheter delivers a first segment of the tubular prosthesis in the ipsilateral lumen and a second segment of the prosthesis in the contralateral lumen.

Systems and methods for systems and methods for focal cooling of the brain and spinal cord are disclosed. Some embodiments may be directed to a neuroprotection system that includes a cerebrospinal fluid processing platform. Embodiments may provide rapid and selective spinal cord hypothermia and drainage. Embodiments may be tailored to selective spinal cord cooling, pressure monitoring and automated drainage. Embodiments may enable local hypothermic neuroprotection, limit the stress of systemic cooling, minimize secondary neuronal damage and achieve maximal neuroprotection while at the same time improving workflow as a result of automated drainage. Embodiments may to include a multi-lumen catheter, a drainage collection reservoir bag, a pump to circulate coolant, sensor hardware and controllers to modulate the flow of a heat transfer fluid for cooling to modulate therapeutic hypothermia and re-warming. Certain embodiments may include extracorporeal cooling of cerebrospinal fluid (CSF). Certain embodiments may include circulating heat transfer fluid within a CSF-containing space near the brain or spinal cord using a catheter. Particular methods may be used to determine the length and amount of cooling.