Methods and tools for implanting prosthetic heart valves and modifying leaflets of an existing valvular structure in a subject are disclosed herein. Prior to or during implantation of the prosthetic heart valve within the existing valvular structure, each tool can be provided in the ascending aorta (or equivalent thereof) of a subject and can be used to pierce, lacerate, slice, tear, cut or otherwise modify a leaflet or commissure of the existing valvular structure. The existing valvular structure can be a native aortic valve or other native heart valve, or a previously-implanted prosthetic heart valve. The modification can avoid, or at least reduce the likelihood of, issues that leaflets of the existing valvular structure might otherwise cause once the prosthetic heart valve has been fully installed, for example, obstruction of blood flow to the coronary arteries and/or improper valve mounting due to a non-circular cross-section.

A tissue specimen removal device comprises a specimen bag; a flexible ring, the flexible ring configured to form a top opening of the specimen bag; a cannula assembly comprising: an inner tube portion and an outer tube portion. The device may further comprise a connector carrier, the connector carrier configured to retain at least one connector housing, the at least one connector housing comprising one or more connector portions and reside within an interior of the connector carrier, and wherein the connector carrier can be moved from a position within the cannula assembly to outside the cannula assembly.

Certain embodiments of the invention relate to a surgical procedure resulting in the fusion of transverse processes. The disclosure herein presents novel approaches for accessing transverse processes of the spine, novel methods for the delivery of fusion material for the fusion of said transverse processes, and novel tools to facilitate the procedure. Certain embodiments of the invention include a graft delivery assembly, which has a delivery shaft, delivery sheath, and at least one curved rod. Bony material is position with a graft delivery assembly, in which retraction of the delivery shaft or sheath places the bone fusion material to the fusion site. The graft delivery assembly further includes features to decorticate and prepare the bone surface for fusion.

Systems and methods for separating native heart valve leaflets attached together by a fixation device. Systems including an elongate shaft having a proximal end portion, a distal end portion and a longitudinal axis extending therebetween, the elongate shaft configured for transvascular delivery of the distal end portion to a native heart valve. At least one arm extending from the distal end portion, and a cutter disposed along at least one of the distal end portion and the at least one arm. The at least one arm is configured to extend through an orifice defined between native heart valve leaflets attached together by a fixation device to position the cutter against one of the native heart valve leaflets adjacent the fixation device, the cutter configured to cut through native heart valve leaflet tissue.

A differential dissecting instrument for differentially dissecting complex tissue is disclosed. The differential dissecting instrument comprises a handle and an elongate member having a first end and a second end, wherein the first end is connected to the handle. The differential dissecting instrument comprises a differential dissecting member configured to be rotatably attached to the second end and further comprises at least one tissue engaging surface. The differential dissecting instrument comprises a mechanism configured to mechanically rotate the differential dissecting member around an axis of rotation, thereby causing the at least one tissue engaging surface to move in at least one direction against the complex tissue. The at least one tissue engaging surface is configured to selectively engage the complex tissue such that the at least one tissue engaging surface disrupts at least one soft tissue in the complex tissue, but does not disrupt firm tissue in the complex tissue.

Extraction devices for extracting chronically implanted devices such as leadless cardiac pacemakers (LCP). In some cases, the extraction devices may be configured to cut or tear through at least some of the tissue ingrowth around and/or over the chronically implanted device such that a retrieval feature on the chronically implanted device may be grasped for removal of the chronically implanted device.

Extraction devices for extracting chronically implanted devices such as leadless cardiac pacemakers (LCP). In some cases, the extraction devices may be configured to cut, tear or ablate through at least some of the tissue ingrowth around and/or over the chronically implanted device such that a retrieval feature on the chronically implanted device may be grasped for removal of the chronically implanted device. Implantable medical devices such as LCPs may include features that facilitate their removal.

An exemplary surgical device includes a shaft with a lumen defined therethrough and an element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen; wherein motion from the stored position to the deployed position causes a first leg of the element to advance distally relative to the distal end of the shaft, and causes a second leg of the element to move proximally relative to the distal end of the shaft.

An instrument and method for creating a precise capsulorhexis as a step in cataract surgery is described. The instrument has a curvilinear cutting band attached to a longitudinal support component and cutting band extending on two sides of the support. In an embodiment, the cutting band has a sinusoidal shape. The support is coupled to a supporting structure, and then to a handle, the supporting structure is shaped to permit it to pass through an incision at a side of a cornea of the eye while positioning the cutting band on an anterior surface of an anterior capsule of a lens of the eye. In an embodiment of the method, the incision in the anterior capsule is formed by pressing the cutting band into the anterior capsule, and capsulorhexis is extended by tearing away the two tabs formed and defined by curvature of the cutting band.

A rotational atherectomy device for removing a stenotic tissue from the iliac artery of a patient. The device comprises a flexible, rotatable drive shaft having an elongated proximal portion, an elongated distal portion. An abrasive element is mounted to the drive shaft between the elongated proximal and distal portions of the drive shaft and between and spaced away from a pair of counterweights which are mounted to said elongated portions of the drive shaft. The eccentric abrasive element and the counterweights are configured for rapid rotation together with the drive shaft, the drive shaft is configured to extend throughout an entire length of the iliac artery to be treated. One elongated portion of the drive shaft extends out of the patient through a first access opening located in a femoral artery which is ipsilateral to the treated artery. Another elongated portion of the drive shaft extending through a second access opening located in another peripheral artery of the patient. A method of treating an iliac artery of a patient using such a rotational atherectomy device.