The present disclosure provides a pump for supporting heart function, that includes a housing with a rotor disposed within the housing and spaced from an internal surface of the housing to define a clearance therebetween. An impeller is coupled to the rotor for propelling blood from a first inlet to an outlet of the housing along a primary blood flow path. The housing includes a second inlet fluidly coupled to the clearance between the rotor and the housing to define a secondary flow path through the clearance. The blood flowing through the secondary flow path continuously flushes the space between the rotor and the housing to minimize the formation and/or growth of blood clots and/or to remove heat generated by the pump. The secondary flow path may also provide a fluid bearing for the rotor and/or the impeller to reduce or eliminate contact surfaces and/or mechanical bearings between the rotating components of the pump and its housing, thereby reducing wear on these components and increasing the longevity of the pump.

Apparatus and methods are described including a device configured for insertion into a left ventricle of a heart of a subject. A delivery tube is coupled to the device and configured to traverse an aortic arch of the subject while the device is within the left ventricle. An elongation-resistant fiber runs axially along the delivery tube so as to bias an orientation of the delivery tube while the delivery tube traverses the aortic arch such that the elongation-resistant fiber is disposed inside a curve of the aortic arch, thereby biasing an orientation of the device. Other applications are also described.

Disclosed herein are systems and methods relating to an implant device, such as a heart pump. The implant device may comprise an implant, a fastening device, a release device, and a transfer device. The implant may be shaped for implantation in a vascular canal. The fastening device may have a coupling section that is coupled to the implant and is movable between a fastening position, in which the fastening device is configured to fasten the implant in the vascular canal, and a release device, which may be configured to transfer the fastening device to a release position and releases the implant. The transfer device may be coupled to the fastening device and is adapted to cause transfer of the fastening device between the fastening position and the release position in response to an actuation.

Disclosed herein are systems and methods relating to an implant device, such as a heart pump. The implant device may comprise an implant, a fastening device, a release device, and a transfer device. The implant may be shaped for implantation in a vascular canal. The fastening device may have a coupling section that is coupled to the implant and is movable between a fastening position, in which the fastening device is configured to fasten the implant in the vascular canal, and a release device, which may be configured to transfer the fastening device to a release position and releases the implant. The transfer device may be coupled to the fastening device and is adapted to cause transfer of the fastening device between the fastening position and the release position in response to an actuation.

A controller for an implantable medical device including a housing sized and configured to be received within a patient, the housing having a thermally conductive shell defining an exterior surface. At least a portion of the exterior surface of the thermally conductive shell defines at least one from the group consisting of a plurality of corrugations and a plurality of protuberances.

Apparatus and methods are described including a left-ventricular assist device that includes a pump-outlet tube shaped to define one or more blood-outlet openings and including a narrower section, and a wider section, which is proximal to and wider than the narrower section, and which is shaped to define at least a portion of each of the blood-outlet openings such that a normal vector to the portion has a distally-facing component. The pump-outlet tube is inserted, through the subject's aorta, into the subject's left ventricle such that the pump-outlet tube traverses an aortic valve of the subject with the blood-outlet openings being disposed within the aorta. An impeller is disposed within the narrower section of the pump-outlet tube and is configured to pump blood of the subject, through the blood-outlet openings, from the left ventricle into the aorta. Other applications are also described.

Apparatus and methods are provided, including inserting a drive-cable-bearing tube, which includes one or more inwardly-facing ceramic portions, into a body of a subject and through an aorta of the subject, such that the inwardly-facing ceramic portions are within an aortic arch of the subject, while a drive cable, which is coupled to an intracorporeal device at a distal end of the drive-cable-bearing tube and includes one or more outwardly-facing ceramic portions, passes through the drive-cable-bearing tube such that the outwardly-facing ceramic portions are aligned with the inwardly-facing ceramic portions. The drive cable is rotated within the drive-cable-bearing tube, thereby rotating the intracorporeal device, while the outwardly-facing ceramic portions are aligned with the inwardly-facing ceramic portions. Other applications are also described.

Apparatus and methods are described including inserting a drive-cable end of a drive cable, which includes a plurality of coiled wires, and a hollow-shaft end of a hollow shaft, which hollow-shaft end is shaped to define multiple shaft pores, into opposing ends of a coupling tube having a wall shaped to define multiple tabs. The drive cable is coupled to the shaft by pushing at least some of the tabs into the shaft pores, respectively. Other applications are also described.

Apparatus and methods are described including an axial shaft configured for insertion into, and rotation within, a subject's body. A delivery tube extends to the axial shaft, from outside the subject's body, while the axial shaft is within the subject's body. An impeller is coupled to the axial shaft such that, as the axial shaft rotates, the impeller pumps blood of the subject. Proximal and distal radial bearings surround the axial shaft, proximally and distally to the impeller respectively, the proximal and distal radial bearings being configured to radially stabilize the axial shaft while the axial shaft rotates. A proximal bearing housing houses the proximal radial bearing and is coupled to the delivery tube. A drive cable rotates the axial shaft while extending through the delivery tube, and is coupled to the axial shaft within the proximal bearing housing. Other applications are also described.

The present disclosure provides methods for treating pulmonary hypertension in a patient with left ventricular assist device (LVAD) implantation and methods of improving cardiac transplant eligibility in a patient with LVAD implantation. The methods include administering to a patient in need thereof a therapeutically effective amount of macitentan or aprocitentan.