A medical device for at least partially covering and applying force on tissue includes a body having a spanning structure and struts respectively connected to lateral portions of the spanning structure. Inner ends of the struts extend into an area over which the medial portion of the spanning structure extends. The medical device is reconfigurable between extended and retracted configurations. The inner ends of the struts are closer to one another in the retracted configuration than in the extended configuration. The inner ends of the struts are closer to the medial portion of the spanning structure in the retracted configuration than in the extended configuration. Each strut includes an engagement zone configured to engage and apply force on the tissue, at least while the medical device is in the retracted configuration. A web can be connected to the struts and span between the inner ends of the struts.

A tissue anchor is provided for delivery by a deployment tool in a constrained state, the tissue anchor including a shaft; a tissue-coupling element, which includes a wire including a shape-memory alloy; and a flexible elongate tension member, which is distinct from the wire. The flexible elongate tension member includes a distal portion that is fixed to a site on the wire such that, when the tissue anchor is not constrained by the deployment tool, the flexible elongate tension member applies, to the tissue-coupling element, tension that constrains lateral expansion of the tissue-coupling element away from a central longitudinal axis of the shaft, by preventing the tissue-coupling element from automatically assuming a predetermined shape provided by the shape-memory alloy of the wire. Other embodiments are also described.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone. The method includes the following: implanting in bone a first anchor including a first suture construct connected to the first anchor; passing a first adjustable loop of the first suture construct at least one of over or through the soft tissue; coupling the first adjustable loop to one of a first locking feature of the first anchor or a second locking feature of a second anchor; adjusting the first adjustable loop by pulling a first end of the first suture construct; and securing the soft tissue against bone by pulling the first end of the first suture construct.

A method and device for placing a leaflet patch over a heart valve. The device comprises a first atrium anchor and a first ventricle anchor configured to be placed in an atrium, a second atrium anchor and a second ventricle anchor configured to be placed in a ventricle, a first artificial chord configured to attach to the first atrium anchor and the first ventricle anchor, a second artificial chord configured to attach to the second atrium anchor and the second atrium anchor, and the leaflet patch. The leaflet patch is placed partially in the atrium and partially in the ventricle. The leaflet patch comprises a first channel configured to contain the first artificial chord and a second channel configured to contain the second artificial chord. At least one of the anchors comprises a winching mechanism for adjusting the tension of one of the articular chords.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

A tether system for securing a prosthetic heart valve within a patient, the tether system comprising a tether defining a longitudinal axis, and a deformable element coupled to the tether, the deformable element having a first deformed shape in a first condition of the deformable element, and having a second substantially straight shape in a second condition of the deformable element so that, when the deformable element is in the second condition, the deformable element extends in a direction along the longitudinal axis.

Embodiments of the invention describe methods of implanting and setting an adjustable suture structure capable of maximizing and controlling the available range of motion in a defective joint. The adjustable suture structure can augment a joint repair following surgery or be used as a standalone construct. One embodiment involves completion of a standard ligament repair, followed by the implant of anchors to secure sutures between bone locations proximal to the native origin of the repaired ligaments. Each of the sutures is implanted with at least some slack. Once the sutures are secured, the first suture is alternatively tensioned and moved through a range of motion, followed by the same process in a second suture. The steps are performed iteratively until the range of motion is controlled or limited sufficiently to protect the repaired ligaments.

An intervertebral disc repair system comprises an implant and a delivery tool configured to deploy the implant at least partially in a vertebral body of a patient. The implant includes an anchor member and an adjustable suture assembly coupled thereto. The delivery tool includes a proximal handle, an outer tubular member extending distally from the handle, a needle cannula slidably received within the outer tubular member having a sharpened tip for penetrating tissue (e.g., the vertebral body), an inner pusher member slidably received within the needle cannula, and an actuating mechanism coupled to the handle for selectively retracting the needle cannula relative to the outer tubular member and the inner pusher member. At least the anchor member of the implant is releasably received within the needle cannula.

Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical repair construct includes an anchor, a filament having a snare formed on one end and a collapsible loop on another end, and a suture having a plurality of stationary protrusions formed therein. The suture is configured to be coupled to detached tissue and have its ends passed through an opening in the snare. The snare can be collapsed around the suture such that at least one of the suture protrusions is proximal of the collapsed snare. The anchor can be disposed in bone and the filament coupled thereto. Accordingly, collapsing the snare around the suture couples the tissue to bone, and applying tension to a tensioning limb of the filament can collapse the collapsible loop to incrementally tighten and secure the tissue to bone. Other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

An implant assembly includes a first implant member, a second implant member, and a contractible element that is connected between the first and second implant members. The first implant member is configured to be placed against a first bone portion, and the second implant member is configured to be placed against a second bone portion. The contractible element is fixed at a first end to one of the first and second implant members, and movable at a second end with respect to one of the first and second implant members so as to induce tension in the suture, thereby providing a compressive force against the first and second bone portions. The second end can then be fixed with respect to the first and second implant members. The contractible element can contract in length in response to bodily fluids, thereby ensuring adequate post-operative compression. An instrument is also disclosed that is configured to implant the first and second implant members adjacent the first and second bone portions, respectively.