Methods and devices for transvascular prosthetic chordae tendineae implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet anchor having a leaflet suture is secured to the mitral valve leaflet. 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. The suture lock has a body with a suture path extending therethrough. A wall in the housing is movable to reduce the cross section of the suture path. A drive mechanism advances the movable wall to clamp sutures extending through the suture path, in response to rotation of a coupling on the housing.

An epicardial anchor system comprising a tether attachment member defining a portion of a tether passageway configured to receive a portion of a tether extending from a heart valve, a base having a rim defining a void along a circumference of the rim, and a tether capture device adjacent the tether attachment member and hingedly attached to the epicardial anchor, the tether capture device including an opening configured to receive the portion of the tether therethrough and a slot configured to capture the portion of the tether extending through the opening, and an actuation mechanism configured to flip the tether capture device from an unactuated condition to an actuated condition, wherein in the unactuated condition, the tether capture device is spaced from the void defined by the rim, and in the actuated condition, a first portion of the tether capture device is positioned within the void defined by the rim.

An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

A system for treating tissue includes a first fastener including a first anchoring element at a distal end thereof for anchoring the first fastener in a first target portion of tissue extending about a periphery of a tissue defect to be treated and a first suture extending from a proximal end thereof. The system also includes a second fastener including a second anchoring element at a distal end thereof for anchoring the second fastener in a second target portion of tissue extending about a periphery of a tissue defect to be treated and a second suture extending from a proximal end thereof. Furthermore, the system includes a cinch element disposed about both of the first and second sutures and slidable therealong such that a tension applied to the first and second sutures draws the first and second fasteners toward one another to close the tissue defect.

Described here are closure devices and methods for ligating tissue, such as the left atrial appendage. Generally, the closure devices include an elongate body, a snare loop assembly comprising a snare and a suture loop, and a shuttle connected to the snare and releasably coupled to the elongate body and retractable therein. In some variations, the shuttle may be configured to fit into the lumen. In other variations, a handle may be attached to the elongate body, and the handle may comprise a track and a snare control coupled to the track. The handle may be configured to release the shuttle from the elongate body and allow movement of the snare control along the track to retract the snare loop and the shuttle into a lumen of the elongate body.

A method and apparatus for coupling a soft tissue implant into a looking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction

Systems and methods for providing fixation of soft tissue (for example, ligament) to bone by employing a novel multi-piece device. The novel multi-piece device is a ligament fixation system consisting of a larger collar that is initially impacted into a bone aperture, and a smaller plug/bullet-shaped part that is impacted into the larger collar. During ligament repair/reconstruction, the graft is inserted into a bone tunnel with sutures from the graft extending outside the tunnel. The sutures are passed through a collar of the multi-part device and the collar is then inserted into the bone tunnel. The graft suture strands may be tensioned. Subsequently, the smaller plug/bullet-shaped part is impacted into the collar thereby maintaining the tension on the graft sutures. The plug/bullet-shaped part is tightened after the desired tension on the suture is achieved.

A soft suture anchor construct is provided for placement in or against tissue or bone. The anchor includes an all-suture anchor having two ends positioned in a first direction in a pre-deployment configuration. In a deployed configuration, the two ends are positioned in a second direction different from the first direction. The suture anchor construct also includes a filament passing through the anchor at a plurality of passing locations, where the filament changes direction at least once along the direction of the longitudinal axis of the anchor and forms at least one slack line. In the pre-deployment configuration, the filament extends a first length between adjacent passing locations, and in the deployed configuration, the filament extends a second length between adjacent passing locations. The second length is shorter than the first length. The suture anchor construct may be deployed in a bone hole with an inserter, anchor driver, or other deployment device.

A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.