The invention relates to a device for treating blood flow in an internal wound, including a handling member connected to a series of successively narrower tubes, each tube including a liquid-expandable article. The tubes can be pivotably connected to each other, allowing the tubes to conform to the contours of the wound, or fixed together. The tubes can be encased in a liquid-soluble layer that keeps the liquid-expandable article sequestered from liquids. The stepwise-tapering profile of the device allows for its insertion into the internal wound with little or no resistance until fully seated. Upon encountering liquids within the wound, the liquid-soluble layer can dissolve to expose the liquid-expandable article. When exposed to the wound liquids, the liquid-expandable element can expand in volume, providing compressive pressure against internal wound surfaces and minimizing blood loss. The tubes and the liquid-expandable element can include therapeutic agents for treating the wound.

Provided is an occluder, comprising a first disk-shaped structure (10) with a grid, wherein the first disk-shaped structure (10) is woven from at least two groups of braided wires, the two groups of braided wires are crossed to form multiple rings of crossing points, a blocking membrane (20) is also arranged in the disk-shaped structure (10), an edge of the blocking membrane (20) is connected to the outermost ring of crossing points (100) of the multiple rings of crossing points through a sewing wire, and the number of crossing points in the outermost ring of crossing points (100) sewn with the blocking membrane (20) is smaller than the number of all the crossing points in the outermost ring of the crossing points (100), and a position of the blocking membrane (20) near the edge thereof is connected to a ring of crossing points within the outermost ring of crossing points (100) in the multiple rings of crossing points through the sewing wire. The occluder can reduce the possibility of the phenomenon where the edge of the blocking membrane (20) cannot abut against a disk face edge of the occluder, improving the occlusion effect of the occluder.

An apparatus for sealing a puncture includes a positioning member including a proximal end, a distal end sized for insertion into a puncture, an expandable element on the distal end, and a tension indicator on the proximal end. The tension indicator includes a distal housing portion fixed relative to the proximal end, and a proximal housing portion or handle movable proximally relative to the distal housing portion. The handle is biased towards the distal housing portion such that, when sufficient tensile force is applied between the expandable element and the handle, the handle moves away from the distal housing portion. During use, the distal end is introduced through a puncture into a vessel, the expandable element is expanded, and the positioning member is partially withdrawn until the expanded element contacts a wall of the vessel and the handle separates from the distal housing portion, indicating that sufficient tension is applied.

A hemostatic tissue anchor (120, 220, 320, 420, 520) is provided which is configured to be anchored to a cardiac tissue wall. The hemostatic tissue anchor (120, 220, 320, 420, 520) includes an anchor portion (130) supported by releasably positioned at a distal end of a generally elongate anchor shaft (132). The anchor portion (130) is expandable from a first generally elongate configuration to a second expanded configuration such that in the second expanded configuration it can be drawn tightly against the cardiac tissue wall when a tensile force is applied to the anchor portion (130). One or more discs (126, 226, 326) surround the anchor shaft (132). Once the one or more discs (126, 226, 326) are implanted entirely within the cardiac tissue wall, the one or more discs (126, 226, 326) act as a hemostatic seal of an opening through the cardiac tissue wall, through which opening the elongate anchor shaft (132) is disposed. Other applications are also described.

A hemostatic tissue anchor (120) is provided that includes an anchor portion (130) supported at a distal end (192) of a generally elongate anchor shaft (132). A hemostatic sealing element (122) is coupled to and surrounds at least an axial portion of the anchor shaft (132), is configured to be disposed at least partially within a cardiac tissue wall (160) at a target site, and includes a self-expanding frame (124) attached to a sealing membrane (126). The hemostatic sealing element (122) includes an expandable portion (128) that assumes an expanded frustoconical configuration (138) that is defined by the self-expanding frame (124) and the sealing membrane (126), and acts as a hemostatic seal of an opening through the cardiac tissue wall (160), through which opening the anchor shaft (132) is disposed. Other embodiments are also described.

Methods and apparatus are provided for fastening or clamping tissue to tissue or non-tissue layers and for occluding tubular body structures. Tissue fasteners having separate proximal and distal implants, each with self-expanding, radially extending legs are connected together on opposite sides of tissue and non-tissue layers. The legs of the proximal and distal implants are interdigitated in the absence of such layers.

Apparatus and methods for occluding hollow body structures, such as blood vessels, and for attaching tissue layers and/or non-tissue layers together by providing implantable elements on opposite sides of the structure or layers and drawing the implants together to occlude the body structure and/or bring the layers together. The implants are deliverable in a low-profile configuration and self-expand to an enlarged configuration. The implantable elements are delivered by transfixing the body structure, then releasing the implants on opposite sides of the body structure and drawing the implants together to effect an occlusion or attachment. The implants are configured to apply oppositely directed forces to opposite surfaces of the tissue layers at alternate, circumferentially spaced locations and may constrain the tissue in a serpentine pattern or in a direct clamping pattern. The implants grip the tissue in a manner that defines a pressure zone about the transfixion aperture that prevents leakage from the aperture.

Aspects of the present invention provide apparatuses and methods for closing an apical hole in a heart of a subject, including a hole-closure device that includes a tissue-attachment portion configured to attach to cardiac tissue around the apical hole, and a collapsible portion coupled to the tissue-attachment portion and configured to close the hole by collapsing inwardly inside the apical hole.

A hemostatic device for sealing a puncture of a vessel includes a first tube defining a first lumen, and a malecot coupled to the first tube. The malecot is selectively actuatable from a neutral configuration to a stopper configuration. The hemostatic device also includes a second tube circumscribing at least a portion of the first tube. The second tube at least partially defines a second lumen and a third lumen. The second tube includes a first opening in flow communication with the third lumen and positioned proximally relative to the malecot. The second tube is selectively orientable to at least partially expose a hemocoagulant agent retained in the second lumen.

Medical devices, systems, and methods reduce the distance between two points in tissue, often for treatment of congestive heart failure and often in a minimally invasive manner. An anchor is inserted along an insertion path through a first wall of the heart. An arm of the anchor is deployed and rotationally positioned according to a desired alignment. Application of tension to the anchor may draw the first and second walls of the heart into contact along a desired contour so as to effect a desired change in the geometry of the heart. Additional anchors may be inserted and aligned with the first anchor to close off a portion of a ventricle such that the ventricle is geometrically remodeled and disease progression is reversed, halted, and/or slowed.