An intravascular device delivery system has an elongated member with a flexible hypotube. The hypotube can be rotationally keyed to a steerable catheter. The flexible hypotube includes one or more cuts to allow bending of the flexible hypotube within a first plane. The steerable catheter is steerable to bend the flexible hypotube within the first plane, and longitudinally movable relative to the flexible hypotube to allow distal movement of the steerable catheter relative to a distal end of the flexible hypotube.

The invention provides a heart valve leaflet capture device (250) comprising a cardiac catheter probe having a proximal end for manipulating the device (250) and a distal end terminating in a transvalve element (256). The transvalve element (256) is configured to pass through a heart valve generally parallel to a longitudinal axis of the catheter and includes two or three leaflet gripping elements (252). The leaflet gripping elements (252) are individually movable by operation of an associated actuating mechanism (260) between a radially retracted position, in which they are withdrawn with respect to the transvalve element (256), and a capture position, in which they diverge outwardly at an acute angle from the transvalve element (256). In the capture position, each leaflet gripping element (252) defines a convergent capture zone that is directed towards the edges of a target valve leaflet and in which the target valve leaflet may be captured.

A heart valve anchor apparatus may include a body having a proximal portion and a distal portion. The body may include a first radially expandable portion at the proximal portion of the body, a second radially expandable portion at the distal portion of the body, and a root portion extending from the first radially expandable portion to the second radially expandable portion, the root portion having an outer extent. The first radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. The second radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. In an unstressed configuration, the body may define a longitudinal centerline that extends away from a plane tangent to the root portion.

A method comprises advancing an elongate tube to a target implantation site, the elongate tube having a needle disposed at least partially therein that has a coiled sutureform wrapped around at least a portion thereof, contacting a distal end of the elongate tube to a target tissue, projecting a tip of the needle from the distal end of the elongate tube to pierce through the target tissue such that the tip of the needle and at least a portion of the coiled sutureform project through the target tissue, advancing a pusher device within the elongate tube and over the needle to push the at least a portion of the coiled sutureform off of the tip of the needle, and proximally pulling one or more suture tails associated with the coiled sutureform to form the coiled sutureform into a knot on a distal side of the target tissue.

The present disclosure provides embodiments of a method for improving coaptation of the anterior and posterior mitral valve leaflets by applying a remodeling force to the posterior leaflet. In particular embodiments, a tension member is secured at a location on or proximate to the posterior leaflet. Tension can be applied to the tension member in a direction superiorly and anteriorly toward the interatrial septum. The tension member can be secured at a location proximate the septum to maintain the tension. The tension provides the remodeling force, pulling the posterior leaflet superiorly and anteriorly to improve coaptation with the anterior leaflet.

The disclosure pertains to valvuloplasty devices which include a first outer shaft, a second inner shaft, a plurality of elongate members disposed therebetween and adapted to be expanded radially by relative motion between the first outer shaft and second inner shaft and a circumferential member disposed about the central portions of the plurality of elongate members, wherein the circumferential member is urged by radial expansion of the plurality of elongate members to contact the valve to be treated thereby effecting a valvuloplasty and methods of use therefor.

A catheter may be used for treating chronic venous insufficiency (CVI) by remodeling a venous valve within a vein. The catheter is advanced through the vein to a position proximate the venous valve, the catheter including a hollow needle extendable out a first side wall of the catheter and an inflatable balloon located on a second, opposing, side wall of the catheter. The inflatable balloon is inflated in order to urge the catheter towards a vessel wall opposite that of the inflatable balloon. The hollow needle is advanced at least partially into the vessel wall opposite that of the inflatable balloon and a bulking agent is injected near the venous valve in order to remodel the venous valve. The bulking agent may be injected within a subintimal space within the vessel wall, or into an advential space outside of the vessel wall.

Methods and devices for transvascular prosthetic chordae tendineae implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet anchor having a leaflet suture is secured to the mitral valve leaflet. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae. The suture lock has a body with a suture path extending therethrough. A wall in the housing is movable to reduce the cross section of the suture path. A drive mechanism advances the movable wall to clamp sutures extending through the suture path, in response to rotation of a coupling on the housing.

A cassette is disclosed for use in a prosthetic suturing device. The cassette has a base. The base has a pair of pivots, a pair of alignment tabs, and at least one retention latch. The cassette also has a cover coupled to the base. The cover has at least one retention latch. The cover also defines one or more ferrule holders. The cassette further has one or more needles guided by the base and the cover. A surgical suturing device is also disclosed for use with a cassette. The suturing device has a cassette receiver and one or more needle drivers, each needle driver having a needle receiver positioned within the cassette receiver.

Valve devices for replacement of mitral valves while preserving valvular and subvalvular mitral valve apparatus. The valve device may be configured as a double orifice valve replacement device, and may include an anchoring and manifold assembly coupleable to a delivery catheter. The assembly may include means for anchoring the device to the mitral valve or to a fixation device already attached to the mitral valve. A peripheral ring anchoring system secured to the assembly may include at least one expandable anchoring ring that is expandable within an orifice of the mitral valve so as to surround the orifice perimeter. A helical suture may be helically disposable about the ring, securing the ring to adjacent leaflet tissue. A trap door valve including a trap door body that seals against the anchoring ring during systole and unseals during the diastolic portion of the cardiac cycle may be provided.