A vascular closure device configured to seal a puncture site in the vessel wall in a more efficient manner is disclosed. The vascular closure device includes a guide member that extends through a portion of the sealing device and that is removable from the portion the sealing device.

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.

An apparatus for sealing a puncture includes a positioning member including a proximal end, a distal end sized for insertion into a puncture, an expandable element on the distal end, and a tension indicator on the proximal end. The tension indicator includes a distal housing portion fixed relative to the proximal end, and a proximal housing portion or handle movable proximally relative to the distal housing portion. The handle is biased towards the distal housing portion such that, when sufficient tensile force is applied between the expandable element and the handle, the handle moves away from the distal housing portion. During use, the distal end is introduced through a puncture into a vessel, the expandable element is expanded, and the positioning member is partially withdrawn until the expanded element contacts a wall of the vessel and the handle separates from the distal housing portion, indicating that sufficient tension is applied.

A device for regulating blood pressure between a patient's left atrium and right atrium, and apparatus for delivery the device, are provided. The delivery apparatus may include one or more latching legs, a release ring, a pull chord, and a catheter wherein the latching legs are configured to engage the device for delivery. The inventive devices may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. The inventive devices may be used, for example, to treat subjects having heart failure, pulmonary congestion, or myocardial infarction, among other pathologies.

An implantable closure device for sealing an opening, such as a puncture, through a biologic tissue membrane, such as the meninges, against leakage of biological fluid. The closure device includes a fluid sealing plug configured to be positioned at least partially within the opening through the biologic tissue membrane. A retainer is configured to secure the fluid sealing plug at least partially within the opening. The retainer includes a proximal retainer portion configured to be disposed proximally on the biologic tissue membrane, a distal retainer portion configured to be disposed distally on the biologic tissue membrane, and a central retainer portion connecting the proximal retainer portion and the distal retainer portion. The central retainer portion is configured to extend through the opening. The fluid sealing plug is coupled to the central retainer portion.

Systems, devices, and methods for providing an endoluminal transhepatic access to a patient pancreaticobiliary system in an endoscopic procedure are disclosed. An example of a transhepatic access procedure comprises navigating a steerable elongate instrument through a body cavity or channel and exiting to a access site of liver, puncturing the liver from the access site, extending the steerable elongate instrument through the liver and into the pancreaticobiliary system and performing an operation therein. Following the operation, the steerable elongate instrument can be retreated, and the access site of liver can be closed with a closure means. Apparatus and methods of training a machine-learning model and using said model to identify patient candidacy for retrograde access based on images of patient anatomy are also disclosed.

An insertable catheter device includes a shaft including a proximal end and a distal end, an expandable balloon, and an actuator configured to expand and retract the expandable balloon. The actuator includes a fluid conduit that extends through the shaft and is coupled with the expandable balloon to enable inflation and retraction of the expandable balloon via injection or withdrawal of a fluid to or from the expandable balloon via the fluid conduit. The expandable balloon is displaceably retractable into the shaft and extendable from the shaft. A fluid pump is coupled with the fluid conduit to pump the fluid through the fluid conduit. A patch is positioned to be displaced by the expandable balloon when the expandable balloon is inflated, and the expandable balloon is displaceably retractable into the shaft and displaceably extendable from the shaft.

Devices, systems and methods for cardiac and vascular access configured to allow for intracardiac access to conduct medical procedures. The devices, systems and methods are particularly useful in trans-cardiac extra-corporeal membrane oxygenation (ECMO) procedures, ventricular assist procedures, cardiopulmonary bypass, or other medical procedures where intracardiac access may be required.

Vascular closure devices along with systems and methods of delivery for deploying the vascular closure devices are described herein.

An epicardial anchor system comprising a tether attachment member defining a portion of a tether passageway configured to receive a portion of a tether extending from a heart valve, a base having a rim defining a void along a circumference of the rim, and a tether capture device adjacent the tether attachment member and hingedly attached to the epicardial anchor, the tether capture device including an opening configured to receive the portion of the tether therethrough and a slot configured to capture the portion of the tether extending through the opening, and an actuation mechanism configured to flip the tether capture device from an unactuated condition to an actuated condition, wherein in the unactuated condition, the tether capture device is spaced from the void defined by the rim, and in the actuated condition, a first portion of the tether capture device is positioned within the void defined by the rim.