Disclosed herein are suture clip delivery devices that can be loaded with several flat, disk-shaped suture clips and can deploy the suture clips one after another onto respective sutures without reloading the device with additional suture clips. An exemplary device includes a handle portion with an actuation mechanism that is coupled to a shaft portion that holds and deploys the suture clips. The shaft portion includes a mandrel on which the suture clips are mounted and a retainer that restricts the suture clips from moving proximally when the actuation mechanism pulls the mandrel proximally, which causes a distal-most suture clip to slide off the mandrel and be deployed onto one or more suture. The mandrel and remaining suture clips can then move distally to prepare to deploy the next suture clip.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet connector carried by a distal end of the catheter can be anchored to a superior surface of a mitral valve leaflet. A needle is axially advanceable through the leaflet connector and through the leaflet. A leaflet anchor having a leaflet suture can be advanced out of the needle to secure the mitral valve leaflet to the leaflet suture. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.

Some suturing devices include a pair of flexible arms configured to force two pieces of tissue together and form a protrusion defined by the two pieces of tissue. Some suturing devices include a third flexible arm including a movable needle configured to apply a suture through both pieces of tissue of the protrusion. Some suturing devices include an actuator configured to move each flexible arm of the pair of flexible arms independently relative to the tissue and move the third flexible arm relative to the tissue. Some suturing devices include a pump configured to generate a suction force through the pair of flexible arms to force the tissue towards the pair of flexible arms.

An auto-suture device includes a spiral drive mechanism having a first spiral drive tube including a cylindrical body having an internal surface defining a first travel path, a second spiral drive tube moveably coupled to the first spiral drive tube, and a first spiral drive element including a drive interface and a needle drive. The needle drive is sized and configured to be received within the first travel path defined by the first spiral drive tube.

An instrument for performing thorascopic repair of heart valves includes a shaft for extending through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a capture valve leaflet and draw the suture therethrough. The suture is thus fastened to the valve leaflet and the instrument is withdrawn from the heart chamber transporting the suture outside the heart chamber. The suture is anchored to the heart wall with proper tension as determined by observing valve operation with an ultrasonic imaging system.

Systems and methods for building a landing zone for an endovascular procedure are described. This procedure is “hybrid” in that it involves both direct access (e.g., sternotomy or partial sternotomy) to the site for installation of the landing zone, as well as endovascular installation of a TAVR or TEVAR device (e.g., stent graft) once the landing zone is installed. The landing zone is installed by wrapping a landing band around a portion of a vessel. The landing band may be selected to be fixed at a diameter so that it inhibits any expansion of the vessel, and also supports a later-installed TAVR or TEVAR device. The TAVR or TEVAR device is then endovascularly delivered to the vessel and deployed therein. The device expands until it contacts the vessel, which is supported from the outside by the landing band, which thus constrains and supports the device from outside.

A suture tool includes a handle portion and a hook portion. The handle portion is preferably a solid shaft of metal material enabling handling by the surgeon. An outside surface of the hook portion is interconnected to one end of the handle portion. The hook portion comprises a hollow U-shaped tube of medical grade stainless steel.

Embodiments include a suture management device including a disk shaped body that defines a top surface that faces away from a body of a patient when the suture management device is coupled to a sleeve of an arthroscopic cannula inserted into the body and a bottom surface that faces toward the body when the suture management device is coupled to the arthroscopic cannula. The suture management device can include a connector configured to couple the disk shaped body to an arthroscopic cannula, and a set of retention features positioned along the disk shaped body, each retention feature in the set of retention features configured to releasably secure a suture.

A device is disclosed that can pierce and hold tissue and then pass suture through tissue. The device can have a shuttle that can removably attach to a suture and jaws that can be rotatably opened and closed with respect to each other. A method for using the device to repeatedly pass the suture through the tissue without removing the suture or device from the target site is also disclosed.

A purse suturing device includes a circular stapler having a tubular stapler head adapted to be inserted inside a section of the hollow viscus to be sutured, a handle with an actuator connected to the stapler head, and an anvil against which the staples may be folded. The anvil has a pole adapted to be inserted into the tubular stapler head. A suturing thread is wound around the hollow viscus and tightened, causing a section of the hollow viscus to be tightened around the pole. The tightened section also includes a pursed, or folded, section of the wall of the hollow viscus, in which two layers of the wall of the hollow viscus are stapled together.