An annuloplasty implant comprising an elongate member configured to be anchored to tissue of a heart, and to move between an elongate configuration and a shortened configuration and a tensioning member. The tensioning member can define a first segment and a second segment such that the first segment extends between a first tensioning-member end and a turn of the tensioning member, and the second segment extends between the turn and the second tensioning-member end. The tensioning member extends along the elongate member such that the elongate member can slide relative to the tensioning member and such that applying tension to the tensioning member causes the elongate member to move from the elongate configuration to the shortened configuration, which can cause the implant to reshape an annulus of a heart valve.

Anchors for securing an implant within a body organ and/or reshaping a body organ are provided herein. Anchors are configured for deployment in a body lumen or vasculature of the patient that are curved or conformable to accommodate anatomy of the patient. Such anchors can include deformable or collapsible structures upon tensioning of a bridging element in a lateral direction, or segmented tubes that can be adjusted by tightening of one or more tethers extending therethrough. Such anchors can be used as a posterior anchor in a blood vessel in implant systems having a tensioned bridging element extending between the posterior anchor and an anterior anchor deployed at another location within or along the body organ. Methods of deploying such anchors, and use of multiple anchors or multiple bridging elements to a single anchor are also provided.

A method for treating a breathing disorder, the method includes providing a tissue retractor that has a shaft having a first end and a second end, an anchor member attached to one of the first end or the second end, and a retractor member attached to the other of the first end or the second end, and inserting the shaft through a soft tissue of a patient's soft palate, wherein the tissue retractor distributes a force on the soft palate thereby changing a size, a stiffness, and/or a shape of the patient's soft palate and preventing obstruction of the patient's airway.

A surgical fastener comprising a generally flat, circular body and a generally cylindrical post fixedly coupled to a center of the body extending perpendicular to the body. Both of the body and the post include through holes configured for passage of a suture. A length of the post is selected to extend through both of a bone graft and at least a portion of bone for providing shear and/or anti-rotational support to the surgical fastener across a fracture line in the bone.

A delivery device includes an inner shaft, an outer sheath, a nosecone, and a tether component. The outer sheath is slidably disposed over the inner shaft. The nosecone is removably coupled to the inner shaft. The nosecone includes a delivery configuration for delivery to a treatment site, a radially compressed configuration in which a portion of the nosecone is configured to traverse through a heart wall, and a radially expanded configuration in which an outer surface of the nosecone contacts an outer surface of the heart wall. The tether component includes a first end coupled to the nosecone. The nosecone is configured to plug a piercing in the heart wall when in the radially expanded configuration.

A heart valve anchor apparatus may include a body having a proximal portion and a distal portion. The body may include a first radially expandable portion at the proximal portion of the body, a second radially expandable portion at the distal portion of the body, and a root portion extending from the first radially expandable portion to the second radially expandable portion, the root portion having an outer extent. The first radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. The second radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. In an unstressed configuration, the body may define a longitudinal centerline that extends away from a plane tangent to the root portion.

Various embodiments of a cartridge for loading a suture onto a suturing instrument are disclosed. In some embodiments, the cartridge is operable for loading a pre-tied knot formed from the suture onto the suturing instrument. The suturing instrument is typically of the type having a suture passing member defining a suture receiving passage therein. In some embodiments, the cartridge comprises a housing defining a chamber, and a partially pre-tied knot mounted about the housing or the chamber. The cartridge additionally provides a base coupled to the housing, the base defining a seat for releasably holding a portion of a suture to be aligned with, and. transferred to, the suturing instrument. The portion of the suture may be held independently, or it may be coupled to a component such as a ferrule or shuttle.

A patient's stomach may be secured to the patient's diaphragm. A method to accomplish this includes visualizing a wall of a patient's stomach adjacent the patient's diaphragm from within the patient's stomach, inserting a fastener deployment apparatus down the patient's esophagus and into the mammalian's stomach, and fastening the patient's stomach to the patient's diaphragm with the fastener deployment apparatus and from within the stomach. The procedure may be employed to advantage to treat a hiatal hernia, for example, either alone or in conjunction with the restoration of the patient's gastroesophageal flap valve.

A tissue anchor is provided that includes a head connected to a shaft, and a tissue-coupling element extending from the shaft. The shaft includes a seal that is configured to form a blood-tight seal between the shaft and a heart wall, and to promote hemostasis. When the tissue anchor is unconstrained, the head is coaxial with an axis of the shaft, and the tissue-coupling element is generally orthogonal to the axis and is shaped such that if the tissue-coupling element were to be projected onto a plane that is perpendicular to the axis, at least 80% of an area of a projection of the tissue-coupling element on the plane would fall within a first angle of 180 degrees in the plane having a vertex at the axis. Other embodiments are also described.

Mitral valve prolapse and mitral regurgitation can be treating by implanting in the mitral annulus a transvalvular intraannular band. The band has a first end, a first anchoring portion located proximate the first end, a second end, a second anchoring portion located proximate the second end, and a central portion. The central portion is positioned so that it extends transversely across a coaptive edge formed by the closure of the mitral valve leaflets. The band may be implanted via translumenal access or via thoracotomy.