Systems and methods for cutting tissue using a transcatheter approach are disclosed. In some examples, the systems and methods are implemented as part of a delivery system that includes an implant with a support structure and a cutting element coupled to the support structure, such that the cutting element configured to cut tissue.

A catheter system (100) includes a light guide (122A) and a light source (124). The light guide (122A) is configured to selectively receive light energy. The light source (124) generates the light energy. The light source (124) is in optical communication with the light guide (122A). The light source can include (i) a seed source (260) that outputs the light energy, (ii) a pre-amplifier (262) that receives the light energy from the seed source (260), the pre-amplifier (262) being in optical communication with the seed source (260), and (iii) an amplifier (264) that receives the light energy from the pre-amplifier (262), the amplifier (264) being in optical communication with the pre-amplifier (262) and the light guide (122A).

A cutting system for use prior to valve replacement that includes a cutting assembly and a sheath. The cutting assembly includes an expansion member that is movable between a stowed position and an expanded position, and at least a first cutting member associated with the expansion member. The first cutting member is configured to incise a first leaflet. The sheath defines a lumen therethrough and the cutting assembly is movable within the lumen.

A catheter for intraluminal lithotripsy including an outer wall, at least one balloon extending from the outer wall, the balloon having a first portion, a second portion proximal of the first portion and an intermediate portion between the first and second portions such that a transverse dimension of the intermediate portion is less than a transverse dimension of the first and second portions. The catheter includes a first lumen, at least one energy emitter mounted on the balloon for emitting energy to break down or soften calcium and a connector connecting the at least one energy emitter to an external energy source, the connector extending through the catheter.

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.

Systems and methods for separating native heart valve leaflets attached together by a fixation device. Systems including an elongate shaft having a proximal end portion, a distal end portion and a longitudinal axis extending therebetween, the elongate shaft configured for transvascular delivery of the distal end portion to a native heart valve. At least one arm extending from the distal end portion, and a cutter disposed along at least one of the distal end portion and the at least one arm. The at least one arm is configured to extend through an orifice defined between native heart valve leaflets attached together by a fixation device to position the cutter against one of the native heart valve leaflets adjacent the fixation device, the cutter configured to cut through native heart valve leaflet tissue.

A catheter system and method for treating a treatment site within or adjacent to a vessel wall or a heart valve within a body of a patient includes an energy source, an inflatable balloon, an energy guide, and an acoustic sensor. The inflatable balloon is positionable substantially adjacent to the treatment site. The inflatable balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide receives energy from the energy source and guides the energy into the balloon interior. The acoustic sensor is positioned outside the body of the patient. The acoustic sensor senses acoustic sound waves generated in the balloon fluid within the balloon interior. The acoustic sensor generates a sensor signal based at least in part on the sensed acoustic sound waves.

A catheter system (100) used for treating a treatment site (106) within or adjacent to the heart valve (108) includes an energy source (124), an energy guide (122A), and a balloon assembly (104). The energy source (124) generates energy. The energy guide (122A) is configured to receive energy from the energy source (124). The balloon assembly (104) is positionable substantially adjacent to the treatment site (106). The balloon assembly (104) includes an outer balloon (104B) and an inner balloon (104A) that is positioned substantially within the outer balloon (104B). Each of the balloons (104A, 104B) has a balloon wall (130) that defines a balloon interior (146). Each of the balloons (104A, 104B) is configured to retain a balloon fluid (132) within the balloon interior (146). The balloon wall (130) of the inner balloon (104A) is positioned spaced apart from the balloon wall (130) of the outer balloon (104B) to define an interstitial space (146A) therebetween. A portion of the energy guide (122A) that receives the energy from the energy source (124) is positioned within the interstitial space (146A) between the balloons (104A, 104B) so that a plasma-induced bubble (134) is formed in the balloon fluid (132) within the interstitial space (146A).

A laceration device for use in medical procedures includes a shaft having a proximal portion defining a proximal end, and an opposed distal portion defining a distal end. A perforation electrode is at the distal end, and a first electrical connector extends proximally from the perforation electrode for connection to a power source. An outwardly extending barb is positioned proximal of the distal end. The barb has an inner end proximate the shaft and an outer end opposite the inner end. A laceration electrode is proximal of and adjacent the inner end of the barb, and a second electrical connector extends proximally from the laceration electrode for connection to the power source.

The disclosure provides various embodiments of catheters having articulable ends that can be used for various procedures. Embodiments of methods are also provided that can be performed with catheters in accordance with the present disclosure.