Transcatheter device for the treatment of calcified native heart valve leaflets comprising an outer hollow shaft (5), an inner hollow shaft (4) slidingly contained within said outer shaft (5) and an axle body (6) slidingly contained within said inner shaft (4); wherein the device comprises a commissure debridement system (7), located at the distal end of the axle body (6), that is made of at least two radially expandable arms (7) that are adapted to be inserted in and aligned with native commissures.

A surgical instrument includes a cutting assembly, an outer tubing, and a flexible torque component. The cutting assembly extends from a first proximal end to a first distal end. The cutting assembly includes an outer cannula defining a cutting window and an inner cannula disposed within the outer cannula. The outer tubing extends from a proximal tubing end to a distal tubing end. The distal tubing end is coupled to the outer cannula. The outer tubing is configured to receive a torque at the proximal tubing end and transmit the torque to the outer cannula to rotate the outer cannula. The outer tubing includes a plurality of first wires and a plurality of second wires each including more than eight wires and less than twenty four wires. The flexible torque component is coupled to a third proximal end of the inner cannula to rotate the inner cannula.

A treatment system for debriding a treatment area of a tissue site and applying negative pressure is disclosed. In some embodiments, the treatment system may include an ultrasonic bubble generator fluidly coupled to a negative-pressure source, fluid source, and a dressing. Fluid may be drawn from the fluid source to the ultrasonic bubble generator, whereby micro-bubbles and ultrasonic waves may be generated in the fluid before the fluid is instilled to the dressing.

A fluid jet is directed at tissue to erode tissue with a controlled amount of ablative energy of a jet. Embodiments as described herein can provide controlled removal of ocular tissue, and can remove a pre-defined volume having a pre-determined shape, for example. The accurate tissue removal as described herein can have many applications, such as removal of the lens for cataract surgery to more completely remove the cortex and nucleus of the lens and to separate layers of the lens. The length of an ablation depth extending from an opening that releases the jet can be controlled, and the angle and longitudinal position of the opening can be controlled together, in order to ablate a pre-determined volume of tissue having the surface profile.

An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.

An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.

A surgical instrument includes a cutting assembly, an outer tubing, and a flexible torque component. The cutting assembly extends from a first proximal end to a first distal end. The cutting assembly includes an outer cannula defining a cutting window and an inner cannula disposed within the outer cannula. The outer tubing extends from a proximal tubing end to a distal tubing end. The distal tubing end is coupled to the outer cannula. The outer tubing is configured to receive a torque at the proximal tubing end and transmit the torque to the outer cannula to rotate the outer cannula. The outer tubing includes a plurality of first wires and a plurality of second wires each including more than eight wires and less than twenty four wires. The flexible torque component is coupled to a third proximal end of the inner cannula to rotate the inner cannula.

A treatment system for debriding a treatment area of a tissue site and applying negative pressure is disclosed. In some embodiments, the treatment system may include an ultrasonic bubble generator fluidly coupled to a negative-pressure source, fluid source, and a dressing. Fluid may be drawn from the fluid source to the ultrasonic bubble generator, whereby micro-bubbles and ultrasonic waves may be generated in the fluid before the fluid is instilled to the dressing.

A catheter treatment apparatus comprises an elongate tubular member and an expandable support. The expandable support comprises a radioactive substance to treat cancerous tissue and is configured to expand from a narrow profile for insertion to a wide profile to engage and treat tissue remaining after resection. The expandable support can be sized to fit within a volume of removed tissue to place the radioactive substance in proximity to the capsule and remaining tissue, to spare the capsule and proximate nerves and vessels to treat tissue in proximity to the capsule. The elongate tubular member may comprise a channel such as a lumen to pass a bodily fluid such as urine when the expandable support engages the tissue to treat the patient for a plurality of days. The treatment apparatus can be used to resect and diagnose tissue concurrently. Based on the diagnosis, targeted segmental treatment may be given.

An apparatus to treat a patient, the apparatus comprises a carrier having a proximal end and a distal end, an optical fiber to couple to a light source, a fluid delivery element comprising a nozzle having an orifice on the distal end, and an alignment structure to align the optical fiber with the orifice. A distance extends between the alignment structure and the orifice, such that the light beam emitted from the optical fiber diverges so as to allow energy transmission and fluid flow through the orifice. In some embodiments, the apparatus to ablate tissue comprises a source of pressurized fluid, and the nozzle is coupled to the source of pressurized fluid to release a fluid stream.