The present invention provides methods and devices for grasping, and optional repositioning and fixation of the valve leaflets to treat cardiac valve regurgitation, particularly mitral valve regurgitation. Such grasping will typically be atraumatic providing a number of benefits. For example, atraumatic grasping may allow repositioning of the devices relative to the leaflets and repositioning of the leaflets themselves without damage to the leaflets. However, in some cases it may be necessary or desired to include grasping which pierces or otherwise permanently affects the leaflets. In some of these cases, the grasping step includes fixation.

The present invention provides methods and devices for grasping, and optional repositioning and fixation of the valve leaflets to treat cardiac valve regurgitation, particularly mitral valve regurgitation. Such grasping will typically be atraumatic providing a number of benefits. For example, atraumatic grasping may allow repositioning of the devices relative to the leaflets and repositioning of the leaflets themselves without damage to the leaflets. However, in some cases it may be necessary or desired to include grasping which pierces or otherwise permanently affects the leaflets. In some of these cases, the grasping step includes fixation.

An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

A non-invasive wound closure device without use of any needles, sutures, staples or tissue-adhesives, to reapproximate the everted edges of a wound of a patient, has two side strips each containing a customized bandage adhered to either side of the wound that is closed by mating and mechanistically interlocking the two side strips, that can also be reopened by mechanistically unlocking and separating the mated side strips, and that can be then reclosed by repeating the closure process. Each side strip has interlocking feature(s) to securely lock them in place with or without an additional interlocking strip or an interlocking slider and has an integral adhesive-bandage layer on the bottom to adhere to the patient's skin. The device may be made in various lengths to encompass a variety of wounds or in a plurality of segmented side strips so as to align the device along a curved wound.

An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

System and method for fixing bone. An exemplary system may comprise a clamping instrument, a first fastener, and a second fastener. The clamping instrument may include a first tube and a second tube. The tubes may have an adjustable separation from one another while remaining coaxially aligned with one another on an axis, and may be configured to apply pressure to opposite sides of a bone to compress the bone. The first fastener may be configured to pass through the first tube on the axis. The second fastener may be configured to attach to the first fastener and to pass through the second tube on the axis. In some embodiments, the system also may comprise an insertion tool configured to carry the second fastener into the second tube and prevent the second fastener from turning.

A closure device of the present invention includes two closure elements, and two sheet materials for integrally disposing the two closure elements. Each of the closure elements includes a base portion, a drawstring portion integrally extending from the base portion, and an adjustment portion including an engaged portion having a shape engageable with the drawstring portion. The base portion of one closure element of the two closure elements and the adjustment portion of the other closure element of the two closure elements are integrally disposed on one of the sheet materials, and the adjustment portion of one closure element and the base portion of the other closure element are disposed integrally on the other of the sheet materials.

System for fixation of leaflets of a heart valve including an implantable fixation device including a first distal element and a second distal element, a first proximal element moveable relative to the first distal element between a first position and a second position, and a second proximal element moveable relative to the second distal element between a first position and a second position. The system further includes a delivery device including a catheter having a proximal end portion and a distal end portion, the implantable fixation device releasably coupled to the distal end portion of the catheter, the catheter defining at least one lumen extending between the proximal end portion and the distal end portion. The delivery device further includes a first proximal element line extending through the at least one lumen, the first proximal element line coupled to the first proximal element and actuatable to move the first proximal element between the first position and second position, and a second proximal element line extending through the at least one lumen, the second proximal element line coupled to the second proximal element and actuatable to move the second proximal element between the first position and second position. The first proximal element line and the second proximal element line are independently actuatable.

Embodiments of invention are directed to tissue approximation instruments that may be delivered to the body of a patient during minimally invasive or other surgical procedures. In one group of embodiments, the instrument has an elongated configuration with two sets of expandable wings that each have spreadable wings that can be made to expand when located on opposite sides of a distal tissue region and a proximal tissue region and can then be made to move toward one another to bring the two tissue regions into a more proximate position. The instrument is delivered through a needle or catheter and is controlled by relative movement of a push tube and control wire wherein the control wire can be released from the instrument via rotation in a first direction and can cause release of the approximation device from tissue that it is holding by rotation in the opposite direction.

Embodiments of invention are directed to tissue approximation instruments that may be delivered to the body of a patient during minimally invasive or other surgical procedures. In one group of embodiments, the instrument has an elongated configuration with two sets of expandable wings that each have spreadable wings that can be made to expand when located on opposite sides of a distal tissue region and a proximal tissue region and can then be made to move toward one another to bring the two tissue regions into a more proximate position. The instrument is delivered through a needle or catheter and is controlled by relative movement of a push tube and control wire wherein the control wire can be released from the instrument via rotation in a first direction and can cause release of the approximation device from tissue that it is holding by rotation in the opposite direction.