A system and method used to deliver a percutaneous ventricular assist device (pVAD) or other cardiac therapeutic device to a site within the heart, such as a site at the aortic valve. A flexible device is percutaneously introduced into a vasculature of a patient and positioned to run from a femoral vein, through the heart via a transseptal puncture, and to a femoral artery. The venous-side end of the flexible device is withdrawn out the venous vasculature superior to the heart, and a pVAD is secured to the flexible device. The pVAD is pushed in a distal direction while the arterial-side end of the flexible device is pulled in the proximal direction to advance the pVAD to the target site. A left ventricle redirector aids in orienting the pVAD and preventing migration of the flexible member towards delicate structures of the heart during advancement of the pVAD.

A catheter body of a guiding catheter configured to be introduced into the renal artery, the catheter body including a plurality of abutting portions abutting at least two sites of the inner wall of the aorta on the abdominal side relative to the heart when the distal portion is disposed in the renal artery. A method for using a guiding catheter for the renal artery including providing the guiding catheter for the renal artery; inserting the guiding catheter from an artery in the arm and disposing a distal portion of the guiding catheter in the renal artery via the aorta; and causing the plurality of abutting portions to abut the inner wall of sections further on the abdominal side than the heart, in the aorta.

A catheter comprises a flexible polymer catheter body including a proximal shaft section and a distal working section, a wire support structure embedded within the distal working section of the catheter body, a proximal adapter mounted to the proximal shaft section of the catheter body, and a wire disposed within the catheter body. The wire has a proximal end and a distal end. The proximal end of the wire being operably connected to the proximal adapter, and the distal end of the wire is anchored to the wire support structure.

An intravascular device delivery system has an elongated member with a flexible hypotube. The hypotube can be rotationally keyed to a steerable catheter. The flexible hypotube includes one or more cuts to allow bending of the flexible hypotube within a first plane. The steerable catheter is steerable to bend the flexible hypotube within the first plane, and longitudinally movable relative to the flexible hypotube to allow distal movement of the steerable catheter relative to a distal end of the flexible hypotube.

A tube or skeleton for a steerable catheter includes a cylindrical body structured to permit bending in at least one bending direction and to resist bending in directions transverse to the bending direction. The cylindrical body may include a laser cut metal tube, wires bent and connected to one another, or one or more coiled wires with axial support wires attached to the coil to define one or more bending directions to form bending segments. The skeleton includes axially stiff portions that resist compression when a pull wire is pulled to cause bending movement. The axially stiff portions may include a backbone, an alignment of pivot structures, connected axially extending portions of wire elements, or axially extending support wires or rods. Two or more bending portions may be provided, each with different bending directions. Complex bending shapes may be provided by arranging the segments in rotated positions along the skeleton.

A guiding sheath assembly has a shaft that is operable to define more than one deflection curvature and defines a lumen to slidably receive a cardiovascular catheter. The guiding sheath assembly includes a proximal section, a distal section, and a stiffener member. The proximal section has a proximal shaft that defines a proximal lumen extending distally along a longitudinal axis to the distal section. The distal section has a distal shaft that defines a distal lumen that is configured to be biased (e.g., resiliently biased) laterally away from the longitudinal axis. The stiffener member is a rigid elongate member, such as an inner tubular member, that is configured to counteract the bias of the distal shaft. Longitudinal movement of the stiffener member relative to the distal section enables the operator to select and set a deflection curvature of the distal section.

An improved bi-directional steerable catheter is provided. The catheter generally comprises a catheter body, tip section and control handle. The catheter further comprises first and second puller wires extending from the control handle, through the catheter body and into the tip section.

The control handle has deflection means for each puller wire that include a gear, and a carrier to which the proximal end of a puller wire is anchored. The gear is rotatably coupled to a lever controlled by an operator and the gear engages the carrier such that rotation of the gear by the lever results in longitudinal movement of the carrier, which results in deflection of the tip section.

Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. The array can be formed using separate strings of balloons formed along single-lumen balloon tube material. The balloon strings can be twisted together to form a multi-channel bundle, or the balloon strings may be circumferentially separated, each extending axially. Regardless, the balloons along a common lumen may be aligned so as to bend the catheter in a desired lateral direction. The fluid-expandable bodies may include an elastomeric bladder with a fiber braid so that inflation of the bladder shortens the assembly and applies axial tension to articulate the catheter. The elongate flexible structures may be pre-biased so as to form a bend when in a relaxed configuration, with the structures being articulatable from the bend.

The invention provides a deflectable catheter capable of forming many variable radius spiral forms from a single, flexible, distal end section. In one aspect, the catheter employs a variable radius control wire to extend or deform a pre-formed loop structure into a three dimensional spiral-like form or geometry. The ability of a single catheter to create a multitude of shapes and sizes allows users to access to a number of anatomical areas without changing the catheter during a procedure or treatment. In another aspect, the invention encompasses methods of producing deflectable variable radius catheters, where two or more regions of the catheter having common control wires are fused or formed onto one another.

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.