A method of reducing tricuspid valve regurgitation is provided, including implanting first, second, and third tissue anchors at respective different first, second, and third implantation sites in cardiac tissue in the vicinity of the tricuspid valve of the patient. The geometry of the tricuspid valve is altered by drawing the leaflets of the tricuspid valve toward one another by applying tension between the first, the second, and the third tissue anchors by rotating a spool that (a) winds therewithin respective portions of first, second, and third longitudinal members coupled to the first, the second, and the third tissue anchors, respectively, and (b) is suspended along the first, the second, and the third longitudinal members hovering over the tricuspid valve away from the annulus of the tricuspid valve. Other embodiments are also described.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a 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.

Devices, systems and methods for fixating soft tissue to bone. In one embodiment, a repair device system for fixating soft tissue to bone includes a carrier member, multiple anchors, and a bone anchor. The carrier member includes multiple pad portions and a bone coupling portion. Each of the pad portions are aligned with an adjacent pad portion. The pad portions are configured to be positioned over a side of the soft tissue and the bone coupling portion is coupled to the multiple pad portions. Each anchor is sized and configured to extend through the at least one opening defined in one of the multiple pad portions and through the soft tissue. The bone anchor is configured to be coupled to the bone coupling portion and configured to be secured to the bone.

Embodiments of knotless button-suture assemblies for orthopedic stabilization are disclosed. The button-suture assembly includes a button having a first opening, a second opening and a center opening. The assembly further includes a tensioning member having two tensioning member ends exiting from the first opening and the second opening of the button and disposed in the proximal direction. The assembly further includes a locking pin mated with the button through the center opening of the button in such a manner that allows a proximal movement of the tensioning member when a pulling force is applied to the tensioning member ends towards a proximal direction and prevents a distal move-ment of the tensioning member when the pulling force applied to the loose ends of the tensioning member ceases to exist.

A system includes a transcatheterally-advanceable driver and an implant. The implant includes a winch, and a tether that has an end portion. The winch includes a spool, a mount, and a driver interface engageable and drivable by the driver. The mount is coupled to the driver interface such that driving of the driver interface by the driver rotates the mount about a rotation axis. The spool is coupled to the tether, and defines a spool axis that is non-coaxial with the rotation axis. The tether extends away from the winch toward the end portion. The spool is fixedly coupled to the mount such that rotation of the mount about the rotation axis draws the end portion of the tether toward the spool by winding the tether around the spool axis of the spool. Other embodiments are also described.

A tension-distribution device includes a rotationally-symmetric structure and two or more suture-engagement features associated with the rotationally-symmetric structure, the suture-engagement features being configured to receive one or more suture portions therein. The two or more suture-engagement features are evenly spaced rotationally about an axial center of the rotationally-symmetric structure.

A tissue-engaging element is advanced to a heart, while coupled to a guide member. The tissue-engaging element is then coupled to tissue of the heart. An elongate implant is subsequently slid distally along the guide member toward the tissue-engaging element, and the elongate implant is subsequently locked to the tissue-engaging element. Other embodiments are also described.

A catheter device includes a tube, and an extracorporeal unit coupled to a proximal end of the tube. An implant includes a series of anchors and a tether. The series of anchors includes a first anchor and other anchors, arranged along the extracorporeal unit. Each of the anchors includes a tissue-engaging element, and a head that defines an eyelet. The tether extends, along the extracorporeal unit, through the eyelet of each of the other anchors to the first anchor such that (i) the first anchor is advanceable, with a distal end of the tether, distally into and through the tube toward the tissue, and (ii) subsequently, the other anchors are slidable, sequentially, over and along the tether, distally into and through the tube toward the first anchor. Other applications are also described.

Methods and devices for transvascular prosthetic chordae tendinae implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a 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.

Medical devices for cinch and cutting one or more suture, and methods for making and using such devices are disclosed. An example medical device may include a coupler, a sleeve releasably coupled to the coupler, a cutter slidably disposed within the sleeve, and a suture cinching member movable into and out of the sleeve. A wire may extend through and be longitudinally movable within the coupler to move the suture cinching member and cutter.