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and spreads ultraviolet (UV) light from ainternal optical fiber, and applies pressufrom each side of the wall to stabilize andtivate the adhesive on the distal side of thefect. We demonstrate proof of conceptthree representative examples of the cloof the described congenital or acquired defeintracardiac defects, abdominal wall hernand perforated peptic ulcers. This list isno means exhaustive and can potentiallyextended to defect closure of any hollow vceral organ defects (for example, perforatiin the bowel, bladder, and esophagus).

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A transcatheter light-reflectingtechnology that delivers andactivates a photocurable adhesiveThe concept and envisioned clinical appcations for the catheter-based closure deare depicted in Fig. 1A, for application in itracardiac defect closure, abdominal herrepair, and peptic ulcer closure. In brief, tconcept of the catheter-based device isUV light is delivered via an internal fiber optic to a reflective balloon where it is reflectonto a patch precoated with photocurable ahesive (Fig. 1B) to affix the patch to ttissue, before removal of the device. Tfunctional components of the device includa reflective distal balloon fixed on an innshaft and a proximal stabilizing balloon oan intermediate shaft (Fig. 1C). All compnents could be loaded into an outer shaA UV fiber optic (connected to a UV sourcat one end and designed for light dispersat the other) was housed in the inner shand could be advanced into the inner lumuntil the tip was located in the distal ballooThe reflective distal balloon has an outer lathat allowed temporary suture-based attament of a patch/adhesive system (Fig. 1C),suring that the patch unfolds with the ballooand can be released from the system in situ.

All components could be deflated anloaded into the outer catheter shaft for dlivery (Fig. 1D). The procedural steps arefollows [and depicted in Fig. 1, E (side vieand F (view from distal side), and movie S(i) the catheter is delivered through the dfect, (ii) the patch is released by pulling bathe open suture loop connecting the patchan outer membrane on the reflective ballo(iii) balloons are deployed (distal balloofirst, then proximal), (iv) UV light is turnedon to activate the photocurable adhes

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peptic ulcer, abdominal wall, and intracardiac defects. (B) Schematics showing reflection of light rayinside the balloon onto a precoated patch and a simulation of reflected rays. (C) Functional componentsof the device include a proximal balloon, an intermediate shaft, a distal balloon with a secondary ouballoon and removable sutures for temporary patch/balloon coupling, and a patch with a photocurableadhesive. (D) Catheter shaft with functional components loaded and ready for delivery. (E and F) Pro-cedural steps from side (E) and front (F) views on a tissue sample: delivery into cavity, patch releasballoon inflation, adhesive activation, and removal of the device after deploying the adherent patch. Ddistal balloon; PB, proximal balloon; P, patch.

www.ScienceTranslationalMedicine.org 23 September 2015 Vol 7 Issue 306 306ra149 2