Novel deployment devices for use as adjuncts with tissue repair implants. The devices are removeably mounted to mesh tissue repair implant devices to manipulate the devices into position and provide for secure fixation about the periphery of such mesh implant devices by providing guide structures such as grooves for directing and positioning a surgical tacking instrument.

Various methods and devices are provided for reducing the volume of the ventricles of the heart. In one embodiment, a method for reducing the ventricular volume of a heart chamber is provided including the steps of inserting an anchoring mechanism onto dysfunctional cardiac tissue, deploying one or more anchors into the dysfunctional cardiac tissue, raising the dysfunctional cardiac tissue using the anchors, and securing the anchors to hold the dysfunctional cardiac tissue in place. Further, a device for reducing the volume of the ventricles of a heart chamber is provided where the device has one or more clips for placement on dysfunctional cardiac tissue of a heart, one or more anchors for deployment and securement into the dysfunctional cardiac tissue, and a lifting mechanism for raising the one or more anchors and the dysfunctional cardiac tissue.

Apparatuses, systems, and devices usable for annuloplasty are provided. These can include an annuloplasty system comprising a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube having a distal portion that is movable through the lumen of the segment and a distal end passable through an opening in the segment that is in fluid communication with the lumen. One or more tissue anchors are deliverable through the tube, the tissue anchor(s) being shaped so as to define a tissue coupling element. The distal portion of the tube can be removably positioned within the lumen of the segment, and, while so positioned, to deploy the tissue coupling element from the distal end of the tube in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.

A fastening device, comprising an inner tube comprising a proximal end and a distal end and at least one fastener positioned within the inner tube and adapted to advance linearly towards the distal end of the inner tube, and an advancing element which converts rotational motion to linear pushing force on the fastener. In some embodiments of the invention, at least one fastener is adapted to not rotate at all or to rotate at a rate not necessarily the same as any other fasteners or any other elements during linear advancement.

A medical staple is provided with: a rectangular base portion; and a needle portion that extends from one end of the base portion in a substantially arc shape so as to protrude in a predetermined direction with respect to the base portion, wherein the needle portion has a first bending position that is provided between a base connected at the one end and a distal end, and that yields first when a pressing force in a radially inward direction of an arc shape of the needle portion acts on the distal end, and a second bending position that is provided between the first bending position and the base, and that yields first when the pressing force acts in the vicinity of the base of the first bending position.

Systems and methods for fastening tissue include a hollow element and an elongate insertion element. The insertion element has a delivery device including a cone, suture, and needle at a delivery end, and an anchor at an opposite end. The hollow element includes an engagement structure in its interior surface that permits movement of the insertion element through the hollow element in a first direction, and prevents movement of the insertion element through the hollow element in a second direction opposite the first direction. The engagement structure may include a braid or mesh that operates on a finger-trap principle. The hollow element may include an elongate element with a cone, suture, and needle at a delivery end, and an anchor at an opposite end. Alternatively, the hollow element may include a button that incorporates the braid or mesh.

An implant is provided that is operable to be disposed between and fuse two sections of a bone. The implant includes a material that is operable to abut against the two sections of the bone. The material is porous and/or fibrous and is operable to receive at least one cellular growth factor.

Apparatus, comprising: (i) a catheter (64); (ii) an implant (100), comprising a flexible longitudinal member (102), and a linking member (104) that extends from a first linking site (106a) of the longitudinal member to a second linking site (106b) of the longitudinal member, the implant having: (a) a delivery state in which the longitudinal member is coaxial with the catheter, and at least a portion of the linking member is disposed alongside the longitudinal member, and (b) an implanted state in which a first distance between the first linking site and the second linking site, measured along the longitudinal member, is greater than a second distance between the first linking site and the second linking site, measured along the linking member; and (iii) a plurality of tissue anchors (46), slidable through the catheter and with respect to the longitudinal member. Other embodiments are also described.

One aspect of the present disclosure relates to a tissue integration device. The tissue integration device can be produced by forming a polymer mixture into a shape. The polymer mixture can include a polymer resin and a growth-promoting medium. Next, at least one polymer forming the polymer resin can be oriented in at least one direction. The shaped polymeric material can then be formed into the tissue integration device.

Methods related to delivery of various heart valve implants are described. The implant may be delivered using an ultrasound imaging delivery system. The ultrasound imaging delivery system may be used to deliver a variety of different devices, including mitral valve reshaping devices, mitral valve replacement valves, and others. A deployment catheter carrying an implant having a tissue anchor is advanced to a deployment site in a heart. An imaging element is positioned adjacent the implant and a relationship between the tissue anchor and an anatomical landmark in the heart is visualized. The implant is then attached by driving the tissue anchor into tissue in the heart.