A low profile implant, system and method of deployment includes a frame comprising an elongate body having ends that overlap to form an annular configuration of the frame. A circumference of the frame may be modified by varying an extent of the overlap between the ends of the elongate body. The elongate structure may extend through a sleeve of a number of respective anchor housings of the implant along a first axis, and anchors may be deployed through bores in the anchor housings along a second axis to secure the anchor housings to tissue. The implant may be deployed about and anchored to a valve annulus, and the circumference of the frame, and associated anchored tissue, may be adjusted to reconfigure the valve annulus.

A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

The invention relates to a device for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation assistance element for implantation across the valve; a system including the coaptation assistance element and anchors for implantation; a system including the coaptation assistance element and delivery catheter; and a method for transcatheter implantation of a coaptation element across a heart valve.

An apparatus and method are provided for a syndesmosis treatment construct configured to be placed into a cinched configuration that presses a first bone against a second bone. The syndesmosis treatment construct comprises a proximal fixator to contact the first bone and a distal fixator to contact the second bone. A first suture and a second suture are parallelly looped through the distal fixator. A free splice slidably rides on proximal ends and distal ends of both of the first and second sutures. The distal ends are looped through the proximal fixator and bound within a stitch splice. The proximal ends are passed outside of the stitch splice and through the proximal fixator. The free splices compress and seize the proximal ends during pulling of the proximal ends by a practitioner so as to maintain the cinched configuration.

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 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.

Described herein are devices for approximating targeted tissue by intertwining two or more sutures together. The sutures are attached to the targeted tissue and routed to a twister device. The twister device secures end portions of the sutures and twists them to intertwine the sutures. Controlling the number of twists provides control over the forces applied to the targeted tissue. In conjunction with visualization feedback, real-time adjustments can be made to achieved targeted results, such as elimination of mitral regurgitation when the disclosed methods and apparatus are applied to mitral valve repair.

A surgical tool incorporates a suture guide with and ananchor driver supporting an anchor where the anchor is maintained at a distance from the suture guide until release of a detent mechanism. Thereafter, the anchor is allowed to move into proximity to the suture guide, fixing a suture supported by the suture guide to a substrate, the entire procedure being achievable with a single hand.

Soft suture anchors are disclosed that can be formed into a pre-strung array with a common working suture. Each anchor includes the common working suture and a soft anchor member that is expandable when implanted. This allows first locking an individual anchor into a bone hole followed by tensioning the suture and independently locking the suture at the anchor. A first anchor is implanted through the tendon and the suture is locked. A second anchor is implanted a selected close distance from the first anchor, the working suture is tensioned between the first and second anchors, and the working suture is locked at the second anchor to create a single suture tensioned and locked stitch between the first and second anchor. This process is repeated for each anchor in the array.