A catheter device for repair of the heart by implanting an artificial chord is disclosed. The device comprises a leaflet anchor 10 for placement in a leaflet 12 of a heart valve, wherein the leaflet anchor 10 is arranged to be coupled to the artificial chord 14; and a mechanical gripper device 6 for grasping the leaflet 12 of the heart valve, wherein the gripper device 6 comprises a leaflet anchor channel for housing the leaflet anchor 10 in a folded configuration; the gripper device 6 and leaflet anchor 10 being arranged such that when, in use, the gripper device 6 grasps the leaflet 12, the leaflet anchor 10 can be pushed out of the leaflet anchor channel to pierce the leaflet 12 and form the leaflet anchor 10 into an unfolded configuration so that hooked formations of the leaflet anchor 10 can, in use, secure the leaflet anchor 10 in the leaflet 12.

A device for suture management and tensioning is disclosed. The device for suture tensioning may include a housing having multiple suture channels, a cleat array, several indicator biasing elements, and an actuator movable between an unlocked position, a tensioned position, and a locked position. The cleat array in the device for suture tensioning may also include at least one first cleat movable relative to the housing and colinear with a second cleat fixedly attached to the housing. The device for suture tensioning may also include an indicator biasing element which is colinear with each cleat pair.

A delivery system for delivering a plurality of helical tissue anchors to repair a wall defect. Coaxially contained within the outer sheath are inner tubular members. The first inner tubular member designed to deploy a first helical tissue anchor, a second inner tubular member designed to deploy a second helical tissue anchor, and a centered inner tubular member contains a cinching mechanism. The two helical tissue anchors are connected to a suture or strap that pull the two helical tissue anchors together to close a tissue defect. A cinching mechanism holds the anchors and tissue defect together and cut the suture or strap.

Embodiments of the present disclosure are directed to systems, methods and devices for providing embolic protection in a patient. In some embodiments, the device is configured for implantation in a body vessel including fluid flow. The device may assume, or be constrained to assume, an undeployed state and a deployed state. In the undeployed state, the device or a portion thereof has a substantially linear shape configured to reside in the lumen of a thin needle having a diameter of less than about 0.5 mm (for example), in the deployed state, the device has a primary axis. When the device is implanted the primary axis is approximately perpendicular to the fluid flow. In some embodiments, the device comprises a thin filament body. In the deployed state the filament takes a helical shape. Emboli that are larger than the distance between consecutive turns or windings of the helix are thus filtered by the device and are prevented from causing deleterious conditions such as stroke or pulmonary embolism. The device may be made of a super-elastic alloy. Thus, the device may transition between the undeployed and the deployed states without plastic deformation. Delivery systems and method for implanting such devices are also disclosed.

A surgical fastener instrument (30) includes an outer delivery tube (36); an inner delivery shaft (42), disposed at least partially in the outer delivery tube (36); and a handle (44) coupled to a proximal portion (46) of the outer delivery tube (36), and including a user control element (48) arranged to rotate the inner delivery shaft (42) with respect to the outer delivery tube (36). A suture fastener (32) is removably disposed in the outer delivery tube (36) in an unlocked conical helical configuration. Distal advancement of the inner delivery shaft (42), when one or more portions of one or more sutures (22) pass through respective portions of the suture fastener (32), transitions the suture fastener (32) from the unlocked configuration to a locked planar spiral configuration, in which the one or more sutures (22) are fixedly coupled to the suture fastener (32). Other embodiments are also described.

Disclosed is a medical instrument that includes a first elongated arm and a second elongated arm pivotally attached at a pivoting joint. The first and second elongated arms include a distal end, a proximal end, an inner surface and an outer surface. The first and second elongated arms define, along respective inner surfaces, opposing gripping portions and opposing cutting edges adjacent to the gripping portions. The first or second elongated arms also include a flange that outwardly deflects from either the first or second distal ends and the first and second elongated arms both include an outwardly deflecting flange. Embodiments enable the cutting of sutures at surgical sites possessing numerous sutures in an expedient manner without the instrument catching the sutures. The instrument also includes functionality to remove staples at a surgical site.

Knot placement devices and methods can improve the ease for a user and/or success of ejecting a knot having a knot body and a plug, cutting suture and/or releasing the cut suture. The knot placement device can have an incremental rotational feature to cut the suture. The knot placement device can include first and second actuators configured for forming and ejecting a knot. The second actuator can be reversed in its position to release suture(s) caught within the device.

Systems and methods for closing a tissue defect are disclosed. The systems may include a subcutaneous guide that is placed transcutaneously between two skin access sites and a self-locking strap that may be advanced into the body through a first access site via a first needle and then passed to a second needle. The strap may be withdrawn with the second needle through a second access site to the outside of the body. The strap may be withdrawn from the first needle, leaving the strap placed through both access sites and across the defect. As the subcutaneous guide is withdrawn from the body it pulls the captured strap such that both ends of the strap protrude from the first access site, allowing the strap to be tightened around the defect. Devices for closure of a tissue defect are also disclosed.

A gastrointestinal tissue approximation clip (“GI TAC”) system for approximating tissue defects, the GI TAC system including an applicator that is sized to travel through an instrument channel of an endoscope; a plurality of tissue approximation clips that are transported to a plurality of locations about a tissue defect by the applicator; a suture coupled to at least one of the tissue approximation clips; and a clip approximation means for approximating the tissue approximation clips. The clip approximation means and the tissue approximation clips are sized respectively to travel through the instrument channel, and the tissue approximation clips are adapted to be detachably coupled to the applicator.

Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).