A system for treating mitral regurgitation may include an outer sheath having a lumen extending to a distal end of the outer sheath, an intermediate sheath slidably disposed within the lumen of the outer sheath, the intermediate sheath having a lumen extending to a distal end of the intermediate sheath, and an inner sheath slidably disposed within the lumen of the intermediate sheath, wherein the inner sheath includes a first anchor disposed within a lumen of the inner sheath, the first anchor being configured to penetrate and secure to a first papillary muscle. The intermediate sheath may include a tissue grasping mechanism at the distal end of the intermediate sheath, the tissue grasping mechanism being configured to hold and stabilize the first papillary muscle for penetration and securement of the first anchor to the first papillary muscle.

A cardiac retractor is disclosed. The cardiac retractor has an outer tube. The cardiac retractor also has a fixed collar fixedly coupled to a proximal end of the outer tube. The cardiac retractor further has a fixed link fixedly coupled to a distal end of the outer tube. The cardiac retractor also has an inner tube rotatable within the outer tube. The cardiac retractor further has a fixed key coupled to a proximal end of the inner tube and configured to rotate the inner tube relative to the outer tube. The cardiac retractor also has a keyed link coupled to a distal end of the outer tube.

A surgical instrument includes a mount body, a joint member, an arm, and a working end. The mount body has a top portion, a distal end, a proximal end and a bottom portion. The joint member is pivotally mounted at a distal end portion of the mount body, to allow positioning of a proximal portion of an arm extending distally from the joint member. The joint member is also configured to at least partially constrain movement of the proximal portion of the arm to a plane. The working end is mounted to a distal end portion of the arm. The surgical instrument can be configured as a heart stabilizer or a heart positioner. The joint member may further be configured as a slotted ball, a disk member, or a combination thereof.

Suturing devices and systems used to close openings into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more arms, and one or more needles. One or more sheaths may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

Among other things, there is disclosed structure and methods for maintaining access to a location in the body while reducing or eliminating the potential for pulling an access device (e.g. a catheter) back through an opening. An introducer sheath includes a distal indented portion and a balloon, so that once placed in a desired location through tissue, the balloon can be inflated to anchor the sheath against retraction. In particular embodiments, structure and methods for accessing the pericardial cavity via the right atrial appendage are shown.

Disclosed are various embodiments for an atrial retractor designed to expose the valves of the heart. The device is made in the shape of an interrupted ring with inset legs to reach into the atria. Segments of the ring, legs, and feet may be made of an elastic material to provide force for retraction of tissue to allow the workspace to be accessible for any surgical procedure to the valves.

A cardiac retractor is disclosed. The cardiac retractor has an outer tube. The cardiac retractor also has a fixed collar fixedly coupled to a proximal end of the outer tube. The cardiac retractor further has a fixed link fixedly coupled to a distal end of the outer tube. The cardiac retractor also has an inner tube rotatable within the outer tube. The cardiac retractor further has a fixed key coupled to a proximal end of the inner tube and configured to rotate the inner tube relative to the outer tube. The cardiac retractor also has a keyed link coupled to a distal end of the outer tube.

A retractor is configured to manipulate for vascular structures during minimally invasive surgical procedures such as mitral valve repair. A long wire has a spring loop at one end surrounded by a helical spring coil forming a toroidal ring. The spring maintains a circular shape while expanding and shrinking under manual control to a desired size for initiating and maintaining the retraction. The looping end of the spring wire is enclosed by the helical coil spring. The other end of the long wire is mounted through a frame with two hollow support arms carrying separate sides of the long wire and guiding them through a long support tube to a proximal end of the tube where each separate portion of the long wire attaches to a coupler. The coupler includes a handle or other push/pull mechanism to adjust the size of toroidal ring.

A surgical rib retractor has a housing and a body pivotably coupled to the housing and moveable between a closed position and an open position. The retractor also has a first arm unit coupled to the housing and configured to atraumatically receive tissue. The first arm unit has a first arm, a first strut movable relative to the first arm in a first plane defined by the first arm, and a first frame attached to the first strut. The retractor also has a second arm unit coupled to the body and configured to atraumatically receive tissue. The second arm unit has a second arm, a second strut movable relative to the second arm in a second plane defined by the second arm, wherein the second plane is not parallel to the first plane when the body is in the closed position, and a second frame attached to the second strut.

Several unique intra-cardiac pressure devices, placement catheters, methods of placement and methods of treating heart failure are presented. The intra-cardiac pressure devices presented allow sufficient flow from the left atrium to the right atrium to enable the relief of elevated left atrial pressure and resulting patient symptoms. The intra-cardiac pressure devices are made of a non-braided material.