During a medical procedure, a transseptal fenestration is made at a septum of the heart and a shunt is implanted into the transseptal fenestration. During the same medical procedure, a transapical puncture is made into a left ventricle of the heart. A prosthetic valve is delivered via the transapical puncture and implanted at a mitral valve of the heart. Subsequently to delivering the prosthetic valve and making the transseptal fenestration, the transapical puncture is closed. Other embodiments are also described.

Degree of occlusion is monitored for an occlusive device configured to occlude passage of fluid between two compartments in a lumenal space of a body of a patient. In some embodiments, changes in an electrical signal measured from the body of the patient are induced by perturbing the fluid; for example, by “tagging” a portion of fluid with a perturbation of temperature and/or composition. The degree of occlusion is estimated based on the measured changes. The electrical signal changes may be indicative of fluid movements redistributing the perturbed fluid among the two compartments; for example, by diffusion, mixing, and/or jetting of fluid.

A conformational state of a medical device operated within a body lumen is determined by measuring, using the medical device as an electrode, an electrical parameter which varies in a correspondence with a conformational state (e.g., deployment state) of the portion of the medical device used as the electrode. The conformational state of the medical device is determined, based on the electrical parameter; and an image is presented indicating the determined conformational state. In some embodiments, the electrical parameter is a self-impedance of the portion of the medical device used as the electrode. In some embodiments, current positioning of the medical device is used as part of calibrating a parametric relationship between the electrical parameter and conformational states of the medical device.

Electrical field-guided positioning of a second device within a body cavity, using electrical field mapping information generated from electrical field measurements by electrodes of a first device. The first device, in some embodiments, is a catheter electrode probe, and the second device is an internally implantable and/or operated medical device. An exposed, electrically conductive portion of the second device is optionally configured to be used as an electrical field measuring electrode. A rule is applied to measurements made by this electrode to estimate its position within a body cavity. The rule is generated, in some embodiments, using measurements made by the first device. In some embodiments, electrical measurements are used to guide implantation verification. In some embodiments, electrical measurements are used to guide navigation at and through a septal wall between body cavities.

A medical dispensing device which includes a catheter, an applicator tip at a distal end of the catheter, the catheter and the applicator tip defining a lumen having a longitudinal axis and a distal opening, a plunger in the lumen and movable along the longitudinal axis, and a plurality of elements in the lumen proximal to the distal opening and distal to the plunger, the plurality of elements stacked along the longitudinal axis for dispersement of one element at a time through the distal opening via a force applied by the plunger.

A device, method, and use of a device for temporary management of a wound, such as a wound in a heart. The device has a shaft, a blood flow blocking membrane at the first end of the shaft for blocking blood flow through the wound, and an abutment member that is mounted to the shaft and is axially movable along the shaft towards and away from the blood flow blocking membrane for abutting the wound and holding the blood flow blocking membrane adjacent the wound. The blood flow blocking membrane is resiliently flexible and movable between at least a first collapsed state for inserting the blood flow blocking membrane through the wound, and a deployed state for blocking blood flow through the wound.

An occluder (100) and system. The occluder (100) includes a body (110) including a shaping wire (111) and a spring coil (112), the shaping wire (111) formed by a resilient metal wire and configured to have a predetermined shape, the spring coil (112) sleeved on the shaping wire (111) in order to shape the body (110) with the predetermined shape. Through maintaining the shape of the body (110) by means of the shaping wire (111), the body (110) is able to effectively block the breach (30) in aortic dissection treatments.

Some embodiments are directed to methods and systems for percutaneously treating dissections in a patient's vasculature, such as, without limitation, the aorta. The method can include deploying a catheter containing a collapsed anchoring element, frame, and cover through a first vessel to an entry point of the dissection. The anchoring element can be secured to the second branch vessel. The frame can be expanded in the first branch vessel. The cover can be unfolded over at least a portion of the entry point. The cover then reduces blood flow into the entry point.

A wound closure device comprises a first frame and a flexible tubular section connected to the first frame, the first frame implantable through a wound in a patient's skin into a lumen of a blood vessel with a portion of the tubular section extending out through the skin. The tubular section has a first portion and a second portion, a wall of the tubular section defining a coaxial inner bore. Twisting the first portion relative to the second portion of the tubular section closes the bore is closed in an area of the tubular section between the first and second portions, thereby closing the wound. Also disclosed is an embodiment for closing an opening in a heart, as well as a delivery device, systems, and methods.

The present disclosure provides a variety of prostheses, delivery systems and techniques to facilitate closure of transvascular or transcameral access ports. Various embodiments of prostheses are provided including a plurality of radially expandable discs that can be filled with material to facilitate coagulation and to reduce or stop leakage from punctures in vessel walls.