A tissue anchor system is provided that includes a first tissue anchor, a second tissue anchor that is separate and distinct from the first tissue anchor, and one or more tethers, which are configured to couple the first tissue anchor to the second tissue anchor. When the first tissue anchor is unconstrained, a head thereof is coaxial with an axis of a shaft thereof, and a tissue-coupling element thereof extends from a distal end of the shaft, is generally orthogonal to the axis, and is shaped such that if the tissue-coupling element were to be projected onto a plane that is perpendicular to the axis, at least 80% of an area of a projection of the tissue-coupling element on the plane would fall within a first angle of 180 degrees in the plane having a vertex at the axis. Other embodiments are also described.

Systems, assemblies, and methods are provided herein for fastening of one bone to another bone using one or more sutures. The features herein enable such fastening with a more accurate strength, and which can be more easily fastened in-situ.

A suture system can comprise a first and a second curved double arm needle, and a needle docking device configured to maintain the first and the second curved double arm needles in alignment with and parallel to one another and at predetermined orientations relative to the needle docking device. The system can include a needle manipulating instrument having a distal portion configured to engage the first and the second curved double arm needles while the first and second curved double arm needles are in the needle docking device, and to maintain the needles in predetermined orientations.

A fixation system (900) for the fixation of a first bone fragment (932) relative to a second bone fragment (934); the fixation system (900) comprising at least one first bone engagement element engagable with the first bone fragment (932), wherein the first bone engagement element has an elongate body portion, a proximal end, a distal end, and a passageway extending through the body portion from the proximal end to the distal end, at least one further bone engagement element engageable with the second bone fragment (934) and having a tensile element (920) securement portion for affixing a tensile element (920) to the further bone engagement element; wherein the tensile element (920) passing the first bone engagement element when engaged with the first bone fragment (932) is fixed relative to the further bone engagement element when engaged with the second bone fragment (934) by the tensile element (920) securement portion; such that the first bone fragment (932) is affixed relative to the second bone fragment (934) from tensile stress in the tensile element (920).

Devices, systems and/or methods for fixating soft tissue to bone are provided. In one embodiment, a repair device for fixating soft tissue to bone with a bone anchor includes a soft tissue anchor and one or more flexible members. The soft tissue anchor includes a base with multiple legs extending from the base. The one or more flexible members are coupled to the base and configured to extend from the base to the bone anchor with a fixed length. With this arrangement, the fixed length of the one or more flexible members is configured to maintain a fixed distance between the soft tissue anchor and the bone anchor such that, as the bone anchor is seated into bone, the one or more flexible members pulls the soft tissue anchor down against the soft tissue to fixate the soft tissue to the bone.

Disclosed herein are various exemplary systems and methods for deploying an implant to a target location of a body vessel. The delivery member can include a tubular body including a lumen and compressed distal portion. The delivery member can include a loop wire with a loop opening positioned approximate the compressed distal portion. The delivery member can include a pull wire that has a proximal pull wire portion and a distal pull wire portion connected by a suture linkage. The suture linkage can include a proximal suture knot engaged to the proximal pull wire portion and a distal suture knot engaged to the distal pull wire portion. Pull wire beads positioned on the proximal pull wire and distal pull wire portion can retain the suture knots during proximal translation of the pull wire. The suture linkage can include slack that is effective to prevent premature deployment of the implant.

A suture having a first end for penetrating tissue, an elongated suture body having a periphery; a plurality of retainers on the periphery, and a second end having a variable loop of variable circumference, wherein the variable loop includes a fixed loop slidably engaging the elongated body for slidingly varying the circumference of the variable loop, and wherein the first end may pass through the variable loop to secure tissue as an anchor, the anchor preventing movement of the suture in the direction of deployment of the first end.

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.

A heart tissue gripping device may include a body portion, an elongate shaft, and a tissue gripping member that is attached to the distal end of the elongate shaft. The tissue gripping member being may be positioned adjacent a heart surface by insertion through an incision in the body. The tissue gripping member may releasably attach to tissue of the heart surface to facilitate a surgical instrument in performing one or more procedures. A coupling of the tissue gripping member may releasably attach the surgical device to the tissue gripping member to allow the device to access the tissue of the heart surface.

A clip unit includes: an arm portion including arms extending from a proximal end portion to a distal end portion so as to be openable and closeable; a holder than can hold the arms in a closed state by accommodating the proximal end portion of the arm portion; and a thread grip attached to at least one of the arms and positioned between the arms. In a state where the arms are spread open, a dimension of the thread grip in the opening/closing direction of the arms is equal to or larger than a distance between the arms in the closed state. The thread can be elastically deformed in the closed state.