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.

Apparatus and methods for occluding hollow body structures, such as blood vessels, and for attaching tissue layers together by providing implantable elements on opposite sides of the structure or tissue layers and drawing the implants together to occlude the body structure and/or bring the tissue layers together. The implants are deliverable in a low-profile configuration and self-expand to an enlarged configuration. The implantable elements are delivered by transfixing the body structure, then releasing the implants on opposite sides of the body structure and drawing the implants together to effect an occlusion or attachment. The implants are configured to apply oppositely directed forces to opposite surfaces of the tissue layers at alternate, circumferentially spaced locations and may constrain the tissue in a serpentine pattern or in a direct clamping pattern. The implants grip the tissue in a manner that defines a pressure zone about the transfixion aperture that prevents leakage from the aperture. The implants have a low profile in that they have a relatively short axial dimension relative to their deployed diameter.

The fastener assemblies, systems, and methods of the present disclosure are generally directed to a first T-fastener and a second T-fastener securable to one another through the use of a suture extending therebetween and deliverable to an anatomical location using a minimally invasive technique. For example, a cannula of a needle assembly may be percutaneously deliverable to a treatment site and, through actuation of a hub of the needle assembly, the first T-fastener and the second T-fastener may be deliverable relative to biological tissue to be fastened at the treatment site. The suture may intracorporeally fasten the first T-fastener and the second T-fastener relative to one another for robust securement biological tissue therebetween. As compared to securement using external fixation, the fastener assemblies, systems, and methods of the present disclosure may facilitate intracorporeally fastening tissue while reducing or eliminating certain requirements associated with postoperative care.

The present disclosure provides a minimally invasive spinal annulus fibrosus repairing device, including at least one bone anchor, at least one annulus fibrosus anchor, and at least one suture. The minimally invasive spinal annulus fibrosus repairing device of the present disclosure can be used to repair the annulus fibrosus damage, and can be combined with the use of an annulus fibrosus implant to repair the damaged annulus fibrosus.

A suturing device (1) for suturing parts (5,6) together of a lumen (8) with one or more sutures (3) comprises an actuator (34) having a handle (33) and first and second operating elements (60,68) slideable longitudinally on the handle (33). A tubular shield (35) extends from the handle (33), and a cannula (40) slideable in the tubular shield (35) is connected to the first operating element (60) for urging the cannula (40) between a withdrawn state within the tubular shield (35) to an extended state extending from the tubular shield (35). An elongated push rod (52) slideable in the cannula (40) terminating in a distal hook (55) is coupled to and operated by the second operating element (68). Anchor elements (22) of the suture (3) are located in the cannula (40), and are sequentially urged therefrom by the push rod (52), as the cannula (40) sequentially pierces through the parts (5,6). A loop (26) of the suture (3) is engaged by the hook (55), which is then withdrawn into the tubular shield (35) for engaging the adjustment element (25) of the suture (3) against an abutment face (38) of the tubular shield (35) for in turn drawing the anchor elements (22), and in turn the parts (5,6) of the colon (8) together. The adjustment element retains the parts (5,6) together.

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, including a needle guide defining a path of travel of a needle inserted through the guide, and a tissue manipulator configured to approximate tissue and said needle guide and to position at least a portion of the tissue in the path of travel of the needle, and wherein the tissue manipulator and the needle guide are alignable such that the path of travel crosses a same surface of the tissue a plurality of times.

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.

An implantable device may be provided with first and second bone anchors, at least one suture and a force-generating component. In some embodiments, the first bone anchor is configured to anchor in or on a first bone segment and the second bone anchor is configured to anchor in or on a second bone segment. The at least one suture may interconnect the first bone anchor and the second bone anchor. The force-generating component may be connected to the at least one suture and configured to impart a force thereto. The first bone anchor, the second bone anchor, the at least one suture and the force-generating component may be configured to cooperate together to draw the first bone segment and the second bone segment toward one another with a force in a predetermined range. Methods of device construction and use are also provided.

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.