Methods and apparatus for creating a seam like array of suture stitches joined in series by sequential anchors in bone. The anchors are transtendon implants positioned through the tendon in the original tendon footprint and each array includes four or more anchors. The seam like array extends across at least a portion of the tendon. The stitches can extend generally perpendicular to the direction of the tendon orientation. In rotator cuff repair, the anchors are positioned in the original footprints of the infraspinatus and/or supraspinatus tendons and the seam like array extends in an anterior to posterior direction across the particular tendons torn and repaired. The entire array of anchors can be positioned in the medial half of the original footprints.

A distal end of a guide catheter is transvascularly advanced into a left ventricle of a heart of a subject. While the distal end of the guide catheter remains disposed in the left ventricle, a first tissue anchor of an implant is deployed from the distal end of the guide catheter. Subsequently, the guide catheter is retracted while progressively exposing the implant. Subsequently, a second tissue anchor of the implant is anchored to a posterior annulus of a mitral valve of the heart by deploying at least part of the second anchor within a left atrium of the heart, such that the implant extends from the first tissue anchor, over an atrial side of a posterior leaflet of the mitral valve, and to the second tissue anchor. Other embodiments are also described.

Disclosed are radially expanding debridement tools configured to pass through an access channel present in a first tissue of a living being, expand radially, and create a void in a second tissue of the living being upon being advanced distally through the access channel and into the second tissue while being rotated, wherein the shape of the void comprises at least one step. Further disclosed are debridement systems and methods of treating tissue defects in living beings.

Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.

Methods for sealing a percutaneous puncture in a wall of a body passageway are disclosed herein. The methods include inserting a deployment instrument into the puncture via a toggle along the guidewire, and actuating the deployment instrument to move the first component and the second component relative to each other such that the toggle abuts the wall of the artery proximate the puncture to seal the puncture.

A method can comprise advancing a suction cup at a distal end of a suction catheter into a heart chamber, contacting the suction cup to a heart valve leaflet, and partially axially collapsing the suction cup while applying a negative pressure through the suction catheter and the suction cup and contacting the suction cup to the heart valve leaflet.

Synthetic chord devices and methods for using the same for connecting tissues are provided. Aspects of the synthetic chord device include a flexible cord having an attachment element at both a first and a second end, wherein each attachment element includes a piercing member coupled to a securing member that attaches the flexible cord to a first tissue. At least a portion of the flexible cord can be configured to be secured to a second tissue. Aspects of the invention also include sets of the synthetic chord device with pre-measured flexible cords. The devices and methods of the invention find use in a variety of applications, such as in applications in which it is desired to repair a heart valve.

Suture constructs and methods for soft tissue to bone repairs. The suture construct is a soft, suture-based anchor which is self-cinching and has a specific, accordion-type configuration (i.e., with the ability to fold from a first, extended position to a second, folded or compressed position). The suture-based anchor may be formed essentially of a flexible material such as a high strength surgical suture, suture chain, or suture.

The present disclosure relates to instruments, implant systems, and methods for joining bone and/or tissue portions. The instrument includes a handle portion; an inserter portion comprising an insertion portion and a tip portion; a guide portion comprising a medial end component and a distal end component, the guide portion extending from a distal end portion of the handle portion to a bone engagement end of the inserter portion; a passageway extending through the inserter portion from the distal end of the handle portion to the bone engagement end of the inserter portion; and a hole that extends from an exterior surface of the handle portion and the guide portion to the passageway, wherein the insertion portion and the tip portion of the inserter portion are positioned past the distal end component of the guide portion when the handle portion, the inserter portion, and the guide portion are mated.

Integratable treatment devices, assemblies including a treatment device, at least one anchor, and a tether coupled thereto, and various methods and devices for inserting such devices and assemblies are disclosed herein. The treatment devices can be made of an integratable material that is not fully bioresorbable but promotes native tissue growth in and around the material. Certain methods involve first inserting at least one anchor and then advancing a treatment device via a tether coupled to the at least one anchor. Further various insertion devices that can be used to implant any of the treatment devices herein using any of the methods herein are disclosed.