A catheter system (100) for treating a treatment site (106) within or adjacent to the vessel wall of a blood vessel (108), or the heart valve, includes an energy source (124), a balloon (104), an energy guide (122A), and a balloon integrity protection system (142). The energy source (124) generates energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) has a balloon wall (130) that defines a balloon interior (146). The balloon (104) is configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma is formed in the balloon fluid (132) within the balloon interior (146). The balloon integrity protection system (142) is operatively coupled to the balloon (104). The balloon integrity protection system (142) is configured to inhibit rupture of the balloon (104) due to the plasma formed in the balloon fluid (132) within the balloon interior (146) during use of the catheter system (100).

A catheter system (100) for treating one or more treatment sites (106) within or adjacent to the heart valve (108) includes an energy source (124), a plurality of energy guides (122A), and a balloon assembly (104). The energy source (124) generates energy. The plurality of energy guides (122A) are configured to receive energy from the energy source (124). The balloon assembly (104) includes a plurality of balloons (104A) that are each positionable substantially adjacent to one or more treatment site(s) (106). Each of the plurality of balloons (104A) has a balloon wall (130) that defines a balloon interior (146). Each of the plurality of balloons (104A) is configured to retain a balloon fluid (132) within the balloon interior (146). A portion of at least one of the plurality of energy guides (122A) that receive the energy from the energy source (124) is positioned within the balloon interior (146) of each of the plurality of balloons (104A) so that plasma is formed in the balloon fluid (132) within the balloon interior (146).

An implant removal device having an elongate body having a proximal end and a distal end, the elongate body being resiliently flexible and configured to transmit torque from the proximal end to the distal end with a predetermined turning ratio, and a capture structure extending distally from the distal end and having a capture region, the capture structure being configured to selectively center a deployed implant in relation to a longitudinal axis of the elongate body and the capture region to aid with capture and subsequent removal.

The disclosure provides various embodiments of systems to facilitate the cutting of luminal tissue structures percutaneously.

A method for treating a treatment site within a body of a patient with a catheter system includes generating energy with an energy source; positioning an inflatable balloon substantially adjacent to the treatment site, the inflatable balloon having a balloon wall that defines a balloon interior that receives a balloon fluid; receiving energy from the energy source with an energy guide; guiding the energy with the energy guide into the balloon interior; sensing acoustic sound waves generated in the balloon fluid with an acoustic sensor that is positioned outside of the body of the patient; generating a sensor signal with the acoustic sensor based at least in part on the sensed acoustic sound waves; electrically coupling a system controller to the acoustic sensor; receiving the sensor signal from the acoustic sensor with the system controller; and controlling operation of the catheter system with the system controller based at least in part on the sensor signal, the system controller being configured to recognize one of: (i) normal operation of the catheter system, and (ii) potential damage to the energy guide.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve includes an energy source, a balloon, an energy guide, and an electrical analyzer assembly. The energy source generates energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide is configured to receive energy from the energy source and guide the energy into the balloon interior. The electrical analyzer assembly is configured to monitor a balloon condition during use of the catheter system. The electrical analyzer assembly can include a first electrode, a second electrode, and an impedance detector that is electrically coupled to the first electrode and the second electrode. The impedance detector is configured to detect impedance between the first electrode and the second electrode.

Disclosed herein is a therapeutically active agent usable in the treatment of pulmonary arterial hypertension (PAH), for use in the treatment of pulmonary arterial hypertension, as well as methods of treating PAH, said treatment and methods comprising administering such an active agent and effecting pulmonary artery denervation in the subject. In some aspects, a sub-therapeutically effective amount of the active agent is administered. In some aspects, the method is devoid of administering such an active agent for at least one month subsequent to the denervation. Further disclosed is a method of treating PAH comprising determining a responsiveness of the subject to at least one therapeutically active agent usable in treating PAH; and effecting pulmonary artery denervation in a subject responsive to the active agent(s).

In some embodiments, a method includes delivering to a native valve annulus (e.g., a native mitral valve annulus) of a heart a prosthetic heart valve having a body expandable from a collapsed, delivery configuration to an expanded, deployed configuration. The method can further include, after the delivering, causing the prosthetic heart valve to move from the delivery configuration to the deployed configuration. With the prosthetic heart valve in its deployed configuration, an anchor can be delivered and secured to at least one of a fibrous trigone of the heart or an anterior native leaflet of the native valve. With the prosthetic heart valve disposed in the native valve annulus and in its deployed configuration, an anchoring tether can extending from the anchor can be secured to a wall of the heart to urge the anterior native leaflet towards the body of the prosthetic heart valve.

Devices, systems, and methods for heart-valve annulus repair techniques, comprising a reinforcing device with one or both of a heating mechanism or clamping mechanism. The heating mechanism may function by heating a localized portion of the annulus so as to reduce the circumference of the annulus and/or increase the stiffness of the tissue. The clamping mechanism may function by gathering or pinching an area of tissue to then reduce the circumference of the annulus and/or increase the stiffness of the tissue.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve, includes a light source, a balloon, a light guide and an optical analyzer assembly. The light source generates first light energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The light guide receives the first light energy and guides the first light energy in a first direction from a guide proximal end toward a guide distal end positioned within the balloon interior. The optical analyzer assembly optically analyzes a second light energy from the light guide that moves in a second direction that is opposite the first direction. The optical analyzer assembly includes a safety shutdown system to inhibit the first light energy from being received by the guide proximal end of the light guide.