Systems, devices, and methods for providing access to the heart. The system includes an intracardiac access device comprising an elongate member having a channel extending between a distal end and a proximal end thereof. The intracardiac access device is configured to be advanced through an extrapericardial penetration in the left atrial wall without penetrating the pericardium of the heart. An optional procedural device is configured to be advanced through the channel of the intracardiac access device into an internal chamber of the heart and configured to perform a surgical procedure in the internal chamber of the heart. A working channel of an optional suprasternal access device is configured to facilitate access of the intracardiac access device into the body of the patient by providing a path from a suprasternal opening to a position adjacent the roof of the left atrium.

A system may comprise a first catheter having a first steerable segment and a second catheter disposed within the first catheter. The second catheter may have a second steerable segment. The system may also comprise an imaging element supported at a distal end of the second catheter, a coil reference sensor supported at a distal portion of the second catheter, and a processor in electrical communication with the coil reference sensor. The processor may be configured to determine a position of a distal portion of the first catheter with reference to the coil reference sensor.

A set of devices and associated methodology for percutaneously closing a puncture through the wall of an artery. The method includes inserting a guide wire through a percutaneous entry and into the artery; using the guide wire to guide an insertion of an introducer catheter into the artery; inserting a balloon catheter through the introducer catheter and into the artery; locking a firing mechanism loaded with fasteners onto the introducer catheter, thereby aligning the puncture with a distal working end of the firing mechanism; activating the firing mechanism to fire two or more fasteners onto the artery, each fastener individually tethered to a suture; percutaneously tying the sutures together to draw the fasteners together, closing the puncture.

A fistula treatment system comprises a guide such as a guide coil 1101 which is adapted to extend partially around a tissue tract and an implant element 1102. The implant element 1102 is activated to draw tissue surrounding the tract inwardly.

A suture system can comprise a first and a second curved double arm needle, and a needle docking device configured to maintain the first and the second curved double arm needles in alignment with and parallel to one another and at predetermined orientations relative to the needle docking device. The system can include a needle manipulating instrument having a distal portion configured to engage the first and the second curved double arm needles while the first and second curved double arm needles are in the needle docking device, and to maintain the needles in predetermined orientations.

A method of closing a patent foramen ovale (PFO) including a septum primum and septum secundum is implemented using a suture device including an operational shaft housing an anchor assembly, a needle assembly, and a suture. The method includes advancing an end of the operational shaft to a proximal side of the PFO, positioning a distal portion of the end of the operational shaft on a distal side of the PFO, and actuating the anchor assembly to deploy the anchor assembly on the distal side of the PFO. The method also includes actuating the needle assembly on the proximal side of the PFO to deploy the needle assembly through the PFO and the anchor assembly, thereby deploying the suture through the PFO. The method further includes retracting the anchor assembly into the operational shaft, and withdrawing the distal portion of the operational shaft from the PFO, leaving the deployed suture.

Methods and devices are configured for neurointerventional procedures. The methods and devices enable safe and rapid access to the cerebral or intracranial arteries for the introduction of interventional devices such as to treat stroke and/or other disease conditions. The methods and devices include a vascular access and retrograde flow system that can be used safely and rapidly in the neurointerventional procedures.

A kit for assembling an incision closing trocar comprising a cannula having a lumen, a proximal side, and a distal side is provided, the kit comprises an obturator comprising: a shaft having a distal end and a proximal end; at least two anchor recesses are provided near the distal end of the shaft, wherein each anchor recess retains a corresponding anchor; a handle provided at the proximal end of the obturator, is configured to actuate at least two pushers so as to push the corresponding anchors from the anchor recesses; and at least two holders, removably attached to the distal end of the obturator wherein each of the at least two holders holds a coiled or folded suture having a length and one end, wherein the one end of the suture is attached to the corresponding anchor, wherein the length of the suture can be pulled from the holders by removing and pulling away the holder from the obturator, wherein the obturator is sized to be inserted into the lumen of the cannula from the proximal side, together with the at least two holders so that the holders are exposed beyond the distal side when the obturator is fully inserted in the cannula, and then the holders can be removed from the obturator such that the sutures are outside the cannula.

A closure device for sealing a percutaneous puncture in a wall of a body passageway, the closure device including at least one of a toggle configured to engage an interior surface of the body passageway or a plug configured to engage an exterior surface of the body passageway and a guide wire configured to extend from an outside of the body to inside the body passageway, wherein at least one of the toggle and the plug is associated with the guide wire.

A device for closing an aperture in a vessel wall including a covering member positionable inside the vessel against the internal opening of the aperture and having a dimension to prevent egress of fluid through the aperture. The covering member has a proximal surface and a distal surface, the distal surface having a concave surface and the proximal surface having a raised surface, wherein four openings are positioned in the raised surface. First and second retainers are positionable external of the vessel and first and second connecting members advance the respective first and second retainers toward the covering member.