Provided is an ostomy wafer cutter for enlarging a hole of an ostomy wafer. The ostomy wafer cutter includes an upper element having a locking means to removably lock a blade element. An upper arm is connected to the upper element. A lower element comprises a platform and a central pin for insertion in the hole of the ostomy wafer. A lower arm is connected to the lower element. A handle portion positioned on at least one of: upper arm and/or lower arm, the handle portion graspable and moveable by a user in a cutting position to bring the upper element in close contact with the lower element causing the cutting edge to cut the ostomy wafer enlarging the hole of the ostomy wafer. The proposed wafer cutter efficiently enlarges the opening of the ostomy wafer and is useful for patients having limited dexterity and/or for elderly people.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium, through the mitral valve, and into the left ventricle. A ventricular anchor is deployed from the catheter and into a wall of the left ventricle, leaving a ventricular suture attached to the ventricular anchor and extending proximally through the catheter. A leaflet anchor is deployed to secure a mitral valve leaflet to a leaflet suture, with the leaflet suture extending proximally through the catheter. The leaflet suture is secured to the ventricular suture to limit a range of travel of the leaflet in the direction of the left atrium. Also disclosed is an assembled in situ mitral valve leaflet restraint, having a neo papillary muscle and a neo chordae tendinea.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A medical device for removing an intravascular thrombus includes: a rotatable tubular driving shaft in which a spiral-shaped carrier is provided on an inner surface thereof; a cutting part that is provided on a distal side of the driving shaft and cuts the thrombus; and an elongated resistive body that is disposed in a lumen of the driving shaft and can be rotated relative to the driving shaft.

An end effector comprising a first jaw, a plurality of staple cavities, a first slot, a first longitudinal row of first staples, a second longitudinal row of second staples, a second jaw, an anvil comprising forming pockets, a staple driver, and a firing member is disclosed. The staple driver supports a first staple removably stored in said first longitudinal row and a second staple removably stored in said second longitudinal row. The staple driver and said anvil are configured to co-operate to deform said first staple to a first fired height and to deform said second staple to a second fired height. The firing member comprises a first portion configured to extend through said first slot and a second portion configured to engage said anvil. The anvil further comprises a second slot including a lateral portion extending behind a longitudinal row of said forming pockets.

A lead removal system includes a lead removal device comprising a sheath. The sheath includes a distal separating member configured to separate an implanted lead from adjacent tissue. The sheath also includes a sheath lumen configured to receive a lead engagement device and the implanted lead. A traction applying device is coupled to the lead removal device. The traction applying device is configured to be secured to the lead engagement device and apply traction to the lead engagement device and the implanted lead as the distal separating member of the sheath separates the implanted lead from adjacent tissue.

A punching device for punching a lumen and implanting an implant device includes at least the implant device for punching the lumen and for implantation into the lumen. In addition, the punching device includes an implantation device, a closure device, and an actuation device.

Exemplary embodiments of an apparatus can be provided for obtaining portions or samples of tissue from a target region of a biological tissue. One or more needles can be provided that have a small internal diameter, e.g., about 1 mm or less, and the needles can be configured to extract the tissue portions when the needles are inserted into and withdrawn from the tissue. Windows and/or markings can be provided on the wall of the needles to facilitate access to the sample. The needles can be provided in an enclosure, and an actuator can be provided to direct the needles into the tissue and/or withdraw them. A plurality of tissue portions having known relative locations in the target region can be obtained, and extraction of the tissue portions can be well-tolerated by the tissue as compared with conventional punch biopsies or the like.

This document relates to devices and methods for the treatment of heart conditions. For example, this document provides devices and methods for treating heart failure with preserved ejection fraction, including diastolic heart failure, by performing a pericardial modification procedure.

Methods and devices for harvesting cancellous bone are disclosed. The bone-harvesting device may include a cannula and a bone receptacle in communication with the cannula, wherein the cannula including a cutting surface positioned at or adjacent the distal end, the cutting surface being oriented at an angle, the angle being greater than 90 degrees relative to the longitudinal axis of the cannula, and the harvested bone is adapted to move from a position adjacent to the cutting surface through the cannula into the bone receptacle. The cutting surface of the cannula may be positioned at or adjacent the distal end, and positioned at least in part radially outward of the outer face of the cannula. The cannula may include a cutting surface positioned at or adjacent the distal end and an occluding geometry that partially occludes the distal end of the cannula adjacent the cutting surface. In addition, a suction port may be provided in communication with the bone receptacle.