Methods and apparatus are provided to facilitate the minimally invasive removal of tissue and to facilitate the direct approach to anesthetizing a body wall of a patient. A pull-type cutting device also is disclosed to introduce an opening into the body wall to provide access for intra-chest surgical interventions, for example a minimally invasive biopsy technique as also described for excising target tissue from within a patient, including a nodule from within the patient's lung.

Methods and systems for introducing a delivery device, having a prosthesis, in the heart at or near the apex of the heart are provided. The methods include the steps of piercing the apex of the heart with a tissue piercing end of the delivery device, advancing the prosthesis to the target site and disengaging the prosthesis from the delivery device at the target site for implantation. The valve replacement systems are configured to deliver a replacement heart valve to a target site in or near a heart. The valve replacement system includes a trocar or other suitable device to penetrate the heart at or near the apex of the heart, a delivery member that is movably disposed within the trocar, and a replacement cardiac valve disposed on the delivery member. The delivery member optionally includes mechanical or inflatable expanding members for implantating the prosthetic valve at the target site.

A method for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased valve.

A method includes, receiving from a calibration probe multiple data points acquired in an organ of a patient, each data point including (i) a respective position of the calibration probe, and (ii) a respective set of electrical values indicative of respective impedances between the position and multiple electrodes attached externally to the patient. A mapping between sets of the electrical values and respective positions in the organ is constructed, by performing for each received data point: if the mapping already contains one or more existing data points in a predefined vicinity of the data point, the one or more existing data points are adjusted responsively to the received data point, and if the predefined vicinity does not contain any existing data points, the received data point is added to the mapping. A position of a medical probe is subsequently tracked in the organ using the mapping.

Systems and methods for placing a treatment device within a patient involve advancing a magnetic first introducer into the patient, advancing a magnetic second introducer into the patient, coupling the first introducer with the second introducer via magnetic force, and using the introducer devices to place a treatment device at a desired location within the patient. Optionally, such techniques involve visualization of the introducers or treatment devices during the procedure.

A transseptal punch with a steering mechanism within the punch, such that punch can be steered and deflected within a guide catheter during delivery, to avoid skiving of the guide catheter inner wall by passage of the punch tip through the guide catheter. The punch can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature or to permit optimal approach or access to a puncture site. The punch is able to create holes in the atrial septum of the heart or other structures and is easier to use than punches that are pre-curved near their distal tip since it is easier to advance through accessory catheters.

Devices and methods for assisting cardiac function. In an exemplary embodiment of a device for assisting heart function of the present disclosure, the device includes a first plate and an opposing second plate, each plate having an inner surface, a cardiac processor coupled to at least one of the first plate and the second plate, a bladder having an inner chamber and disposed between the inner surfaces, and a first catheter having a proximal end in communication with the inner chamber of the bladder and a distal end having a first pericardial balloon coupled thereto, wherein a gas and/or a liquid within the inner chamber of the bladder can be injected into the first pericardial balloon upon compression of the first plate relative to the second plate, and wherein the gas and/or the liquid can be removed from the first pericardial balloon upon retraction of the first plate relative to the second plate.

Methods and devices are disclosed that provide therapeutic benefit and treatment for a variety of neurologic and physiologic conditions that include obesity, urinary incontinence, and sensory system disorders.

A transseptal punch with a steering mechanism within the punch, such that punch can be steered and deflected within a guide catheter during delivery, to avoid skiving of the guide catheter inner wall by passage of the punch tip through the guide catheter. The punch can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature or to permit optimal approach or access to a puncture site. The punch is able to create holes in the atrial septum of the heart or other structures and is easier to use than punches that are pre-curved near their distal tip since it is easier to advance through accessory catheters.

Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.