An implant includes an interface and a wing that is coupled to the interface. A catheter is transluminally advanceable to a heart chamber upstream of a heart valve of a subject and houses the implant. A delivery tool comprises a shaft and a driver. Via engagement with the interface, the shaft is configured to (i) deploy the implant out of the catheter such that, within the chamber, the wing extends away from the interface; and (ii) position the implant in a position in which the interface is at a site in the heart and the wing extends over a first leaflet of the valve toward an opposing leaflet of the valve. The driver is configured to secure the implant in the position by driving an anchor through the interface and into tissue at the site. Other embodiments are also described.

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 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.

Tissue repair devices include an advancement assembly comprising a rod portion configured to advance through a needle to expel first and second implants from the needle, a ratchet coupled to a proximal section of the rod portion and configured to advance the rod through the needle by axial and rotational movement, and an advancement member having a linear travel axis including a first bore connected to a second bore. A diameter of the first bore is smaller than a diameter of the second bore such that the first bore and the second bore comprise a stop. The rod portion has mechanical properties optimized to both conform to a needle curvature and provide sufficient compressive strength to expel implants from the devices.

An end effector for use with a surgical device is provided. The end effector includes a drive assembly, a driver, a needle assembly and a biasing element. The driver is disposed in mechanical cooperation with the drive assembly. Rotation of the drive assembly in a first direction causes distal translation of the driver with respect to the drive assembly. The needle assembly is disposed in mechanical cooperation with the driver. Distal translation of the driver causes a corresponding distal translation of the needle assembly. The biasing element is disposed in mechanical cooperation with the needle assembly and is configured to bias the needle assembly proximally.

An example medical system includes a medical device configured to join the edges of the leaflets together, an elongate body configured to be navigated through vasculature to a heart valve of patient, and a plurality of tissue engagement devices extending from a distal end of the elongate body, each tissue engagement device comprising at least one clamp configured to capture leaflets of the heart valve.

Methods, devices, and systems for mechanically reducing the volume of the lung. Some embodiments include endobronchially positioning an anchoring device within a lung, the anchoring device comprising at least a distal anchor, expanding at least a portion of the distal anchor to anchor the distal anchor against lung lumen tissue, and tensioning at least a portion of the device to reduce the volume of the lung.

A tissue repair system for securing a first tissue to a second tissue is disclosed including an instrument with a handle, a shaft extending distally from the handle and a housing having a locked cover. A tissue anchor is disposed at a distal end of the shaft, and operatively coupled to an actuation member of the handle via a deployment member. The actuation member is configured to actuate the deployment member, deploy the tissue anchor and thereby couple the tissue anchor with the first tissue. The system also includes a repair member, for coupling the tissue anchor to the second tissue. Repair member has a first end operatively coupled to the tissue anchor and a second end attached to at least one coupling means. The repair member second end and coupling means are housed within the instrument housing. Actuation of the actuation member is configured to unlock the housing cover.

A traction tool for performing traction, of a suture thread under a flexible endoscope is provided. The traction toot includes a first holder configured to hold the suture thread or a suture needle attached to the suture thread; a second holder having an engaging surface configured to engage the suture, thread such that the suture thread is capable of advancing and retracting and configured to release an engagement with the suture thread; and a guide member holding the first holder and the second holder such that the first holder and the second holder are relatively movable.

A traction tool for performing traction of suture thread under a flexible endoscope is provided. The tool includes a shaft, a first holder which is provided at a distal end of the shaft and is configured to hold the suture thread or a suture needle attached to the suture thread, and second holder which is provided closer to a proximal end side of the shaft than the first holder and to which the suture thread is hooked. The second holder is expandable in a radial direction of the shaft.