A meniscal repair instrument includes an articulating mechanism configured to move a needle on the tip in a controlled arc. Multiple directions of motion are provided in order to facilitate the deployment of suture anchors. In one aspect, the articulating mechanism includes a series of movable members that are coupled together by two wires that are provided with a push/pull force via a control mechanism.

In some embodiments, a method includes delivering to a native valve annulus (e.g., a native mitral valve annulus) of a heart a prosthetic heart valve having a body expandable from a collapsed, delivery configuration to an expanded, deployed configuration. The method can further include, after the delivering, causing the prosthetic heart valve to move from the delivery configuration to the deployed configuration. With the prosthetic heart valve in its deployed configuration, an anchor can be delivered and secured to at least one of a fibrous trigone of the heart or an anterior native leaflet of the native valve. With the prosthetic heart valve disposed in the native valve annulus and in its deployed configuration, an anchoring tether can extending from the anchor can be secured to a wall of the heart to urge the anterior native leaflet towards the body of the prosthetic heart valve.

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. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

A system for repairing tears in soft tissue, e.g., meniscal tissue, by employing cinch stitching. More specifically, the present invention provides an apparatus for meniscal repair using a suture implant construct. The suture implant construct includes a first and second implant which are connected to each other via a length of suture. The implants are designed to be loaded on external surfaces of the first and second trocars.

A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

Assemblies for securing fractured bone are provided. The assembly includes a first fixation element, a second fixation element, and an adjustable flexible member construct. The first fixation element having a male or a female sleeve is secured within a first portion of the fractured bone. The second fixation element having the other of the male or female sleeve telescopically received within the one of the male or female sleeve is secured within a second portion of the fractured bone. The adjustable flexible member construct extends between the first and second fixation elements and has at least one adjustable loop coupled to the first fixation element and the second fixation element and a pair of adjusting ends extending through an opening in the first fixation element. The pair of adjusting ends can be pulled to reduce a diameter of the adjustable loop and to compress fragments of the fractured bone.

A tool to fasten tissue or to fasten a prosthetic to tissue includes a gripper to hold one or more tissue portions, a needle, an actuator to drive the needle, a fastener cartridge to store one or more tissue fasteners, a holder cartridge to store one or more holders, and a holder applier to secure one of the holders on one of the fasteners. The actuator drives the needle and the needle pulls a first fastener from the fastener cartridge. The actuator drives the needle through the one or more tissue portions held by the gripper to form a hole in the tissue portions. The needle pulls a leading portion of the first fastener through the hole without a trailing portion of the first fastener being pulled through the hole. The holder applier secures a first holder from the holder cartridge onto the leading portion of the first fastener.

Various embodiments of anchors are configured to be inserted into a heart wall of a patient to anchor a suture as an artificial chordae under an appropriate tension for proper valve function. Each of the disclosed anchor embodiments “toggles” from a first position for delivery of the anchor to the heart wall and a second position for insertion of the anchor into the heart wall. In some embodiments, it is the “toggle” to the second position that provides the insertion force for inserting the anchor into the heart muscle sufficient to retain the anchor from accidental withdrawal from the heart wall during normal valve operation (e.g., when a valve leaflet pulls on the suture attached to the anchor during systole). Such anchors are particularly suitable for use in intravascular, transcatheter procedures as described above given the inherent difficulties in providing sufficient force for insertion of an anchor into the heart wall with a flexible catheter.

A device for closing an aperture in a vessel wall, the aperture having an external opening in an external region of the vessel wall and an internal opening in an internal region of the vessel wall. The device includes a covering member positionable inside the vessel against the internal opening of the aperture and having a dimension to prevent egress of fluid through the aperture. A securing member is positionable external of the vessel and has a plurality of pores extending therethrough. A flexible connecting member operatively connects the covering member and securing member and moves the securing member toward the covering member.

A suture and button construct, having an oblong button defining at least a first aperture and a second aperture; a suture length, including a braid defining a lumen and having a middle section and two end sections, each extending through a button aperture and both terminating in an end. Both ends have a needle attached. Also, two shuttles are engaged to the suture length, each having a free end and a loop end, terminating in a loop. Each shuttle enters the lumen in the middle section and extend through an aperture, while in the lumen and exit on the opposite button side from the middle section, so that both shuttle loops are available outside the lumen, to pull a suture end through the lumen and a button aperture.