The present disclosure provides a heart valve repair method, comprising: advancing a distal end of a suture implanting apparatus from an outside of a body through a transapical approach into a left ventricle or a right ventricle of a heart; holding each leaflet of a heart valve with the distal end of the suture implanting apparatus; implanting at least one suture into the leaflet; withdrawing the suture implanting apparatus from the body; advancing a distal end of a suture locking apparatus from the outside of a body through a transapical approach into the corresponding left ventricle or the corresponding right ventricle; using the suture locking apparatus to lock the plurality of sutures; and withdrawing the suture locking apparatus from the body. The heart valve repair method has a simple surgical procedure, a low degree of patient trauma, and a high success rate of surgery.

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.

A system for coupling a tendon to a bone may include a tendon coupling device engageable with a tendon, a fastener to secure the tendon coupling device to the tendon, a bone coupling device, and a flexible element. The flexible element may include a first portion and a second portion. The first portion of the flexible element may be couplable with the fastener to securably attach the flexible element to the tendon. The bone coupling device may include a bone-facing surface engageable with a surface of the bone proximate a bone tunnel formed through the bone, and a hole formed through the bone coupling device. The second portion of the flexible element may be receivable through the bone tunnel and the hole formed through the bone coupling device to engage an opposing surface of the bone coupling device and securably couple the tendon to the bone.

A soft tissue repair device. The device includes an inserter having a distal portion, a first anchor carried externally onto the distal portion, a second anchor carried externally onto the distal portion, and a flexible strand coupling the first and second anchors and forming an adjustable knotless loop.

The present disclosure relates to a system for radial cinching of an opening in an internal biological structure. The system includes, a tensioning tube, a plurality of sutures disposed within the tensioning tube, a plurality of delivery tubes. Each delivery tube is configured to receive a distal end of one of the plurality of sutures. The plurality of delivery tubes are further configured to deploy the distal ends of the plurality of sutures proximate a periphery of the opening. Upon deployment of the sutures proximate the periphery of the opening, one or more of the plurality of sutures are cinched while movement of portions of the plurality of sutures are constrained by the tensioning tube causes radial cinching of the periphery to close the opening.

A knotless tensionable fixation system may be utilized for performing surgical methods for repairing tissue defects within a joint. An exemplary surgical method may include fixating a graft over top of the tissue defect with the knotless tensionable knotless fixation system. The knotless tensionable fixation system may include a plurality of knotless suture anchors, the graft, and a reinforcement construct. The reinforcement construct may establish a fixed segment of material over the graft after being secured in place by the plurality of knotless suture anchors.

A surgical method can include passing at least two adjustable loops of a flexible construct through at least the first tissue to extend from an outer surface of the first tissue opposite a tissue engaging surface facing the second tissue, and attaching the two adjustable loops to a first selected area of the second tissue. The method can further include positioning an elongated locking member within the two adjustable loops such that the locking member extends between the two adjustable loops adjacent the outer surface, engaging the locking member with the outer surface by drawing the two adjustable loops towards the outer surface, and compressing the first tissue between the locking member and the second tissue by tensioning the two adjustable loops. Related tissue fixation devices are also provided.

Described herein are reusable surgical needles having a resiliently collapsible rear loop that captures a suture as it is passed through an object and resiliently expands upon exiting the object to release the suture. Also described are suture spool assemblies that include a rigid housing and a rotatable spool of suture material suspended within the housing so that a plurality of sutures can be dispensed from the assembly in succession during a surgery. Also described are annular pledgets having diametrical dimensions similar to an outer ring of a cardiac implant such that a single annular pledget can be used with a plurality of sutures that secure the cardiac implant to native tissue around the perimeter of the cardiac implant. Related methods of suturing cardiac implants are also disclosed.

A closure device (200) includes a filament (204), an anchor (208), a sealing pad (210), and an automatic driving mechanism. The anchor is configured to be inserted through the tissue wall puncture and is attached to the filament at the second end of the closure device. The sealing pad is slidingly attached to the filament at the second end of the closure device. The automatic driving mechanism includes a compaction member (212), at least one slide member (230, 232) at the first end of the closure device, and a biasing member (234). The biasing member is carried by the at least one slide member and operable to distally advance the compaction member for automatically compacting the sealing pad toward the anchor upon withdrawal of the closure device from the internal tissue wall puncture.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium, through the mitral valve, and into the left ventricle. A ventricular anchor is deployed from the catheter and into a wall of the left ventricle, leaving a ventricular suture attached to the ventricular anchor and extending proximally through the catheter. A leaflet anchor is deployed to secure a mitral valve leaflet to a leaflet suture, with the leaflet suture extending proximally through the catheter. The leaflet suture is secured to the ventricular suture to limit a range of travel of the leaflet in the direction of the left atrium. Also disclosed is an assembled in situ mitral valve leaflet restraint, having a neo papillary muscle and a neo chordae tendinea.