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.

This disclosure is for an endoluminal delivery cannula, for delivery of a substance to an extravascular target site via the vascular system of a human or animal body, wherein the cannula comprises a proximal cannula hub, an elongated proximal, and a tip portion. The tip is tapered towards the distal tip which is preferably provided with a pointed tip for penetrating tissue. The pointed tip may comprise at least one primary facet and two secondary facets, wherein the two secondary facets are arranged proximally of said primary facet. An endoluminal delivery assembly comprises the cannula, a protective catheter adapted for insertion into the vascular system of a human or animal body, and a proximal catheter hub provided at the proximal end of the catheter and adapted for guiding the catheter through the vascular system.

An elongated support assembly is positionable, at least in part, in sliding relationship with an elongated flexible medical assembly. The elongated support assembly is configured to support, at least in part, the elongated flexible medical assembly after the elongated support assembly is positioned, at least in part, in sliding relationship with the elongated flexible medical assembly. The elongated support assembly is, at least in part, selectively maneuverable via an elongated ancillary medical assembly toward a distal portion of the elongated ancillary medical assembly.

A trans-apical implant includes a spacer defining spacer cavity configured to be expanded from a retracted position, a shaft extending from the spacer, the shaft defining an inflation lumen fluidly coupled to the spacer cavity and configured to be fluidly coupled to an expansion medium source, and a spacer valve assembly disposed within at least one of the spacer or shaft, the spacer valve assembly configured to allow selectively allow an expansion medium to flow into the spacer cavity to be selectively expand the spacer from a retracted position to an expanded position.

A septostomy device 10 with a cutting structure or means 140 and tissue capture mechanisms 240, 250 is disclosed, along with a medical procedure for using the device. The system 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

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 present teachings provide methods for resizing, reducing, and closing left atrial appendage. Specifically, a percutaneous trans-septal access is first established from outside the body to a patient's LAA. At least two tissue anchors are then implanted inside the LAA chamber and along the tissue wall. At least one anchor is implanted near the opening of the LAA camber. Both tissue anchors are pulled together so that the wall of the LAA chamber collapse. The LAA chamber is therefore resized, reduced, and/or closed off completely. This closure method and system could be used alone in closing LAA chamber. This closure method and system could also be used in addition to other treatment mechanisms, such as filling the LAA chamber with space-filling material, then closing off its opening.

A method and apparatus are disclosed for a device for creating a puncture in a tissue. The puncturing device comprising an elongate member having a puncturing portion at the distal tip. The puncturing device further includes at least one inflatable feature positioned around the outer circumference and at a distal portion of the elongate member. The puncturing device includes a lumen extending from a proximal end of the elongate member to the inflatable feature. The inflatable feature is in a fluid communication with the lumen and can be inflated to dilate the puncture in the tissue or anchor the puncturing device in a heart structure.

Devices and methods for performing a transseptal puncture procedure using a device which includes either an untapered or tapered blunt end cannula disposed in an introducer carrying a sharp guidewire disposed longitudinally through the lumen of the blunt cannula, and a blunt end dilator wherein the guidewire is flexible and has an atraumatic shape at its tip. The cannula gives the more flexible introducer a defined shape and steerabilty allowing an ordinarily skilled physician to easily access a selected location on the septal wall of the heart for transseptal puncture and introducer placement thereacross without employing an exposed sharp end needle during the procedure.