A device includes a first end portion, a second end portion, an intermediate portion between the first end portion and the second end portion, and a graft material coupled to at least the intermediate portion. The first end portion has a first end diameter. The second end portion has a second end diameter larger than the first end diameter. The intermediate portion tapers between the first end portion and the second end portion. A method of diverting fluid flow from a first passage to a second passage comprising deploying the device in a third passage between the first passage and the second passage, expanding the first end portion against sidewalls of the first passage, and expanding the second end portion against sidewalls of the second passage.

The invention generally relates to catheter systems and methods for guided formation of vascular access sites (such as fistulas and grafts). According to certain aspects, a catheter system for forming a vascular access site include an elongate body comprising a distal end and configured to be inserted into a first vessel. The elongate body includes an exit port along its side that is proximal to the distal end. An imaging assembly is associated with the elongate body and configured to generate image data of the first vessel and a second vessel positioned next to the first vessel. For vascular access formation, a penetrating member of the catheter system extends out of the exit port and through a wall of the first vessel and a wall of the second vessel.

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism.

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascular delivery, and full intra-atrial adjustability and retrievability years after implant. The implants or systems of implants and methods also make use of strong fluoroscopic landmarks. The implants or systems of implants and methods make use of an adjustable implant and a fixed length implant. The implants or systems of implants and methods may also utilise an adjustable bridge stop to secure the implant, and the methods of implantation employ various tools.

Devices, systems, and methods to generate a bypass lumen in connection with a chronic total occlusion procedure. An exemplary method comprises introducing at least part of a first elongated body into a lumen of an artery so that a distal tip of the first elongated body is positioned on a first side of an occlusion within the lumen of the artery; inserting the distal tip of the first elongated body into a wall of the artery in between a tunica media and a tunica intima of the artery; advancing the distal tip of the first elongated body in between the tunica media and the tunica intima; and further advancing the distal tip of the first elongated body back into the lumen of the artery to generate a bypass lumen and so that the distal tip is positioned on an opposite second side of the occlusion within the lumen.

The present disclosure is directed to a device. The device may include a distal shaft defining a central lumen and an orienting element comprising at least one inflatable member. Wherein a first portion of the orienting element extending from the shaft in a first direction and a second portion of the orienting element extending from the shaft in a second direction. Further, wherein the second direction is substantially opposite the first direction.

Apparatus and methods are described including inserting a tool into a blood vessel, and, while the tool is within the blood vessel, acquiring an extraluminal image of the blood vessel. In the extraluminal image of the blood vessel, a location of a portion of the tool with respect to the blood vessel is detected automatically. In response to detecting the location of the portion of the tool, a target portion of the blood vessel that is in a vicinity of the portion of the tool is designated automatically. Using the extraluminal image, quantitative vessel analysis is performed on the target portion of the blood vessel. Other embodiments are also described.

A quick-connector for use with an autoretroperfusion and hypothermia system and methods of using the connector. The connector comprises a coolant inlet, a coolant outlet, a coolant reservoir, a blood lumen outlet, a blood lumen inlet, and a blood lumen, whereby the coolant outlet is configured to accept a cooling product from the reservoir, the reservoir is configured to accept cooling product from the coolant inlet. Flowing blood powered by the patient's heart may enter the connector through the blood lumen inlet, travel through the blood lumen while being cooled by cooling product in the reservoir, and leave the connector through the blood lumen outlet. The temperature of blood leaving the connector can be measured at the blood lumen outlet. Catheters can be attached to the blood lumen inlet and blood lumen outlet to receive and send blood, respectively. A cooling system can be attached to the coolant inlet and coolant outlet to provide a source of cooling product.

A method for carrying out a cardiac procedure includes: a. via an inferior artery, advancing a perforating tip of a perforation device towards an aorta; b. positioning the perforating tip adjacent a wall of the aorta, proximate a left pulmonary artery; and c. advancing the perforating tip to perforate through the wall of the aorta and then through a wall of the left pulmonary artery, to create a pathway between the aorta and the left pulmonary artery.

A method for carrying out a cardiac procedure includes a. via a superior artery, advancing a perforating tip of a perforation device towards an aorta; b. positioning the perforating tip adjacent a wall of the aorta, proximate a left pulmonary artery; and c. advancing the perforating tip to perforate through the wall of the aorta and then through a wall of the left pulmonary artery, to create a pathway between the aorta and the left pulmonary artery.