Aspects of the present disclosure are directed toward apparatuses, systems, and methods for stent access and device delivery. In certain instances, the apparatuses, systems, and methods may include a plurality of struts arranged about the one or more cutting blades on a tip portion.

An ablation system, configured to create a shunt between a left atrium and a coronary sinus of a patient, includes an ablation device comprising a proximal body defining a distal-facing surface configured to contact the coronary sinus wall, a distal body defining a proximal-facing surface positioned opposite the distal-facing surface and configured to contact the left atrium wall, and first and second heating elements disposed on the distal-facing and proximal-facing surfaces, respectively. The heating elements are configured to ablate tissue between the left atrium and the coronary sinus of the patient to create the shunt. The system further includes an expandable dilation element configured to dilate a puncture formed through the coronary sinus wall and the left atrium wall to facilitate introduction of the distal body of the ablation device into the left atrium.

Devices, systems and methods for treating diseases and disorders effecting the cardiovascular system of the human body are disclosed. An exemplary device in accordance with this disclosure comprises a shaft, tip member fixed to the shaft, and a probe extending beyond a distal surface of the tip member. In some useful embodiments, the tip member is relatively atraumatic and the probe is shaped so as to be more likely to produce trauma than the tip member.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

The present invention relates to a joining member for an anastomosis system for realizing anastomosis between first and second hollow structures, such as end-to-side anastomosis. The joining member is annular and is adapted for joining the first and second hollow structures. The joining member includes a plurality of interconnected loops forming the annular body and a plurality of joining elements for joining the hollow structures connected to the annular body at locations where adjacent loops are interconnected to each other, and wherein the loops are configured to permit radial expansion of said annular body to expand said joining member from a first position to a second position having a second, larger diameter than the first position.

A device includes a first end portion, a second end portion, an intermediate portion, and a graft material. The first end portion has a first end diameter. The second end portion has a second end diameter smaller than the first end diameter. The first end portion comprises a first material. The second end portion comprises a second material different than the first material. The intermediate portion is between the first end portion and the second end portion. The intermediate portion tapers between the first end portion and the second end portion. The graft material is coupled to at least the intermediate portion.

A method of producing an arteriovenous (AV) fistula includes producing an anastomosis between a primary blood vessel (e.g., a vein) and a secondary blood vessel (e.g., an artery). A collateral (or competing) blood vessel in fluid communication with one of the primary blood vessel or the secondary blood vessel is identified. A reversible flow restrictor is then applied to the collateral blood vessel to reduce a blood flow rate through the collateral blood vessel. In some embodiments, the anastomosis can be produced percutaneously. In some embodiments, the reversible flow restriction (or a portion thereof) can be removed from the collateral blood vessel. In other embodiments, the reversible flow restriction (or a portion thereof) can be adjusted to allow increased blood flow therethrough while within the collateral blood vessel.

A medical device having an elongate body with a proximal portion, a distal portion, and defining a lumen therethrough. The medical device has an expandable element coupled to the distal portion of the elongate body, the expandable element defining a proximal portion, a distal portion opposite the proximal portion and an intermediate portion disposed between the proximal portion and the distal portion. The expandable element also has an inner surface and an outer surface opposite the inner surface. The medical device has a plurality of cutting members, each cutting member being coupled with the outer surface of the expandable element, each cutting member having a proximal end and a distal end opposite the proximal end, the proximal end being proximate the proximal portion of the expandable element and the distal end being proximate to the intermediate portion of the expandable element.

A surgical access system is disclosed. The surgical access system having a cannula may include a distal tip having one or more longitudinal channels distributed around a circumference of the distal tip, and one or more circumferential channels around the distal tip. The surgical access system also includes an obturator coaxially insertable within the cannula which may include a distal tip and a retractable cutting element having an actuator. The surgical access system also includes an articulation interface. The surgical access system may also include a distal tip of the cannula that may further include one or more bridges distributed circumferentially along the one or more circumferential channels of the distal tip. The obturator further may include an elongated tube and a slidable plunger element configured to control fluid flow inside the elongated tube of the obturator.

The present disclosure relates to an ostomy method and an implantation method. The ostomy method includes steps of making an incision in the chest to expose the heart, puncturing the left ventricle with a puncture needle, thrusting the puncture needle into the ventricular septum and then into the right ventricle to form a puncture site on the ventricular septum, and dilating the puncture site of the ventricular septum with a dilator to form an opening. The method of the present disclosure can reduce the death rate.