A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve includes an energy source, a balloon, an energy guide, and an electrical analyzer assembly. The energy source generates energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide is configured to receive energy from the energy source and guide the energy into the balloon interior. The electrical analyzer assembly is configured to monitor a balloon condition during use of the catheter system. The electrical analyzer assembly can include a first electrode, a second electrode, and an impedance detector that is electrically coupled to the first electrode and the second electrode. The impedance detector is configured to detect impedance between the first electrode and the second electrode.

A system for excising an implanted clip approximating opposed valve leaflets in a heart valve includes a capture catheter configured to be introduced proximate the valve leaflets on one side of the clip, a transfer catheter configured to be introduced proximate the valve leaflets on another side of the clip, and a cutting tool configured to be deployed between the capture and transfer catheters and to be engaged against tissue of at least one of the valve leaflets and to excise the clip. A removal catheter may optionally be used to remove the clip from the heart.

The present disclosure is a catheter assembly and related method that allows laceration of either a surgical valve or transcatheter valve leaflet to facilitate flow to the coronary arteries during valve in valve interventions.

A catheter for intraluminal lithotripsy including an outer wall, at least one balloon extending from the outer wall, the balloon having a first portion, a second portion proximal of the first portion and an intermediate portion between the first and second portions such that a transverse dimension of the intermediate portion is less than a transverse dimension of the first and second portions. The catheter includes a first lumen, at least one energy emitter mounted on the balloon for emitting energy to break down or soften calcium and a connector connecting the at least one energy emitter to an external energy source, the connector extending through the catheter.

A catheter system (100) for treating a treatment site (106) includes an energy source (124), a balloon (104), an energy guide (122A), and a balloon integrity protection system (142). The energy source (124) generates pulses of energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) has a balloon wall (130) that defines a balloon interior (146). The balloon (104) is configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive the energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma is formed in the balloon fluid (132) within the balloon interior (146). The balloon integrity protection system (142) is operatively coupled to the balloon (104). The balloon integrity protection system (142) is configured to inhibit temperature-induced rupture of the balloon (104) due to the plasma formed in the balloon fluid (132) within the balloon interior (146) during use of the catheter system (100).

In one embodiment, a medical system includes a catheter configured to be inserted into a heart of a living subject, and including electrodes configured to capture electrical activity of the heart at respective position in the heart, a display, and processing circuitry configured to receive position signals from the catheter, and in response to the position signals compute the respective positions of the electrodes, generate an anatomical map responsively to respective ones of the computed positions, find an anatomical feature of the heart and a position of the anatomical feature responsively to the respective positions of, and electrical activity captured by, respective ones of the electrodes, automatically segment the anatomical map responsively to the found position of the anatomical feature, and render the anatomical map to the display.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) or a heart valve includes a light source (124), a first light guide (122A), a second light guide (122A), and an optical alignment system (257). The light source (124) generates light energy (224A, 224B, 324A, 324B, 424B). The first light guide (122A) receives the light energy (224A, 224B, 324A, 324B, 424B) from the light source (124). The first light guide (122A) has a guide proximal end (122P). The second light guide (122A) receives the light energy (224A, 224B, 324A, 324B, 424B) from the light source (124). The second light guide (122A) has a guide proximal end (122P). A multiplexer (223) directs the light energy (224A, 224B, 324A, 324B, 424B) toward the guide proximal end (122P) of the first light guide (122A) and the guide proximal end (122P) of the second light guide (122A). The optical alignment system (257) determines an alignment of the light energy (224A, 224B, 324A, 324B, 424B) relative to at least one of the guide proximal ends (122P). The optical alignment system (257) adjusts the positioning of the light energy (224A, 224B, 324A, 324B, 424B) relative to the at least one of the guide proximal ends (122P) based at least partially on the alignment of the light energy (224A, 224B, 324A, 324B, 424B) relative to the at least one of the guide proximal ends (122P).

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

Systems, devices and methods for percutaneously modifying leaflets within the heart, thereby facilitating further repair or replacement. In some embodiments, the leaflets are cut. In other embodiments, the leaflets are removed either in part or in whole. The modifications to the leaflets may be made in conjunction with a prosthetic valve or independently.