An adjustable fixation system for coupling a tissue or graft to bone is disclosed including a suture construct including a first limb, a second limb and a body therebetween. The body is continuously braided with the first and second limbs and has a longitudinal passage therethrough. The first and second limbs define a braided portion including a braided core. The suture construct is configured to form at least one adjustable loop formed by passing the first limb between braids of the suture construct, along the longitudinal passage and back out between braids of the adjustable suture construct. Tension on at least one of the first or second limbs reduces a diameter of the longitudinal passage around a length of the first limb and thereby the braided core disposed along the body longitudinal passage and knotlessly locks the adjustable loop.

A prosthetic heart valve may include an expandable stent, a cuff attached to an annulus section of the stent, and a plurality of leaflets disposed within an interior region of the stent and attached to at least one of the cuff or the stent. The stent may have a plurality of cells connected to one another in a plurality of annular rows around the stent. The leaflets together may have a coapted position occluding the interior region of the stent and an open position in which the interior region is not occluded. Each leaflet may include a primary leaflet material, as well as features that reinforce specific regions of the leaflet.

Implants, devices, systems, and methods for achieving ligament fixation are disclosed. An implant comprises a cap member comprising an internally threaded opening extending from a first end thereof, an anchor portion comprising a first end that defines a tip of the implant and external threads, and a coupling portion extending between the cap member and the anchor portion. The coupling portion of the implant includes an externally threaded portion threadably coupled within the internally threaded opening of the cap member. The cap member of the implant is longitudinally moveable along the coupling portion. Insertion instruments for inserting an implant for ligament fixation are also disclosed. Methods of using an implant for achieving ligament fixation are also disclosed.

A graft tensioning tool includes an elongate frame having a proximal end, a distal end, and an axial passage extending therethrough. The distal end is configured to detachably engage a tunnel ring at an entrance to a tunnel in bone, and the frame includes a first suture puller and a second suture puller. Each suture puller detachably engages a length of suture emerging through the attached to suture and/or a soft tissue implant in the bone tunnel. A tensioner on the elongate frame displaces the suture pullers in a proximal direction to apply a controlled tension to the suture lengths and/or implant. A tension gauge measures tension applied to the suture pullers, and a locking tool is configured to engage the suture lock through the axial passage of the frame, allowing a user to fix the suture ends to bone when a target tension is attained.

Described are surgical implants that include releasable reinforcement, and related methods, particular example implants and methods being useful for treating pelvic tissue, cardiac tissue, and hernia, wherein the releasable reinforcement can be released (removed or disabled) during a surgical procedure to affect a mechanical property of the implant or a portion of the implant.

A hybrid prosthetic heart valve configured to replace a native heart valve and having a support frame configured to be expanded post implant in order to receive and/or support an expandable prosthetic heart valve therein (a valve-in-valve procedure). The prosthetic heart valve may be configured to have a generally rigid and/or expansion-resistant configuration when initially implanted to replace a native valve (or other prosthetic heart valve), but to assume a generally expanded form when subjected to an outward force such as that provided by a dilation balloon or other mechanical expander. An inflow stent frame is expandable for anchoring the valve in place, and may have an outflow end that is collapsible for delivery and expandable post-implant to facilitate a valve-in-valve procedure.

A medical device may include a tubular sleeve configured for implantation in a body lumen, the sleeve having a first configuration with a first rigidity and a second configuration with a second rigidity greater than the first rigidity, the sleeve including: a flexible membrane defining an interior lumen; and a channel extending along the membrane.

Fixation device for fixation of leaflets of a heart valve includes an elongate central member defining a longitudinal axis of the fixation device and first and second arms rotatable about at least one arm hinge point between an open position and a closed position. The fixation device further includes a first gripping element rotatable about a first gripping element axis of rotation to capture a first leaflet of a heart valve between the first gripping element and the first arm. The fixation device further includes a second gripping element rotatable about a second gripping element axis of rotation to capture a second leaflet of a heart valve between the second gripping element and the second arm. At least one of the first gripping element axis of rotation and the second gripping element axis of rotation is variably offset from the arm hinge point by an axis offset distance defined along the longitudinal axis.

A method and system for secure attachment of tissue to bone and other anatomical structure is disclosed. The system includes an all-suture anchor assembly including an all-suture anchor having at least one suture strand and an all-suture anchoring element threaded along the suture strand. The system also includes an adjustable self-locking device including a length of suture passing through at least one clinching portion.

Embodiments of the present disclosure include a cardiac device comprising a band configured for deployment within a heart. The band may include a first end and a second end, an actuatable clasp associated with the first end of the band and configured to transition, upon actuation, from an open configuration to a closed configuration for forming the band into a fixed length loop after the second end is moved beyond the clasp. The clasp may be configured for actuation via a catheter. The cardiac device may include a clasp retainer associated with the clasp, the clasp retainer being configured to hold the clasp in the open configuration and the clasp being configured to be actuated upon movement of the clasp retainer, and a clasp actuator configured to move the clasp retainer thereby actuating the clasp.