Methods of attaching a soft tissue to an adjacent bone at a defect site are provided. An adjustable loop region of a flexible construct contained in a bore defined by a fastener is passed through a tissue. The adjustable loop is passed through the tissue. The fastener is passed back through the adjustable loop to fold the adjustable loop upon itself. The fastener is attached to the bone. An adjusting arm on the flexible construct is engaged to reduce the size of the adjustable loop and secure the soft tissue to the bone.

A fistula treatment system comprises a guide such as a guide coil 1101 which is adapted to extend partially around a tissue tract and an implant element 1102. The implant element 1102 is activated to draw tissue surrounding the tract inwardly.

A medical device includes a surgical needle, an elongated suture, and an intervening segment. The elongated suture has a first end proximate to the needle and a second end located away from the needle. The elongated suture also includes a plurality of fibers defining a mesh wall between the first and second ends. A plurality of pores extend through the mesh wall, at least some which are in the macroporous size range of greater than 200 microns for facilitating tissue integration when introduced into a body. The intervening segment is disposed between and connected to either or both ends of the elongated suture and the needle. The intervening segment includes one or more fibers of the plurality of fibers and has a cross-sectional dimension smaller than a cross-sectional dimension of the mesh wall such that the intervening segment facilitates indirect attachment of the elongated macroporous mesh suture to the needle.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

An apparatus for implantation at an annulus (75) of an intracardiac valve includes an annuloplasty ring (110) comprising a plurality of rotatably adjoining segments (112). The ring is configured to pass over multiple threads (58), respective distal ends of which are distributed over the annulus, and, while passing over the threads, expand from a collapsed state to an expanded state by virtue of the segments rotating with respect to each other. The apparatus further comprises a lock (114), configured to lock the ring in the expanded state at the valve by inhibiting rotation of the segments with respect to each another. Other embodiments are also described.

Embodiments of the invention include methods and devices for securing a suture, graft, or other material to tissue with an anchor. The anchor of some embodiments includes an eyelet through which the suture, graft, or other material may be passed and mechanisms for selectively engaging the suture, graft, or other material through the eyelet. The mechanisms of some embodiments may also reinforce the anchor to provide a strengthened anchor to withstand actions such as impacting the anchor during insertion or applying bending stress to the anchor.

Meniscal repair devices, systems, and methods are provided.

Several embodiments are set forth of devices, systems and methods for modifying an atrial appendage such as a left atrial appendage (LAA). In one embodiment, a medical device includes a frame member and a tissue growth member. The frame member includes a unitary, seamless central portion having a plurality of struts defining a multi-cellular structure and an anchoring system, the plurality of struts extending between and configured to self-expand and directly bias the anchor system to anchor the frame member at least partially within the LAA. With this arrangement, the tissue growth member is attached to the frame member to occlude the LAA.

A suture anchor system comprising an anchor and an insert, and methods of use are provided. The anchor body has proximal and distal ends, and opposite first and second lateral sides extending between the proximal end and the distal end. A suture passage comprising a proximal surface and a distal surface extends through the anchor body from a first opening in the first lateral side to a second opening in the second lateral side. A channel extends along a longitudinal axis of the anchor body from a proximal opening in the proximal end of the anchor body to a distal opening in the proximal surface of the suture passage. The channel does not extend past the distal surface of the suture passage. The insert is configured to translate longitudinally within the channel between the proximal end of the anchor body and the distal surface of the suture passage.

Described herein is a simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a hole in a boney tissue, apply tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the bone while maintaining suture tension and without introducing spin to the suture.