A bone suture assembly including a flexible generally cylindrical sleeve, a plurality of lengths of suture extending through the generally cylindrical sleeve, and at least one sleeve securing thread associated with the generally cylindrical sleeve. A bone suture retaining method including engaging a suture with a bone engaging sleeve, inserting the suture and the bone engaging sleeve engaged thereby into a transosseous tunnel formed into a bone by pulling the bone engaging sleeve into the transosseous tunnel and retaining the suture and the bone engaging sleeve in the transosseous tunnel by virtue of the bone engaging sleeve being unable to fit through an aperture in the bone.

The present disclosure involves a system and method of use for delivering an interventional instrument, such as an artificial chordae tendineae (ACT) delivery instrument, into a beating heart. By delivering interventional instruments in a beating heart via the system described here, complex and invasive open heart procedures as well as cardiopulmonary bypass can be avoided, significantly reducing patient trauma and recovery time as well as operation time and complexity. The system disclosed includes an optical imaging system to provide the practitioner with visual imagery from the end of the system, and allow for real-time or near real-time imaging of tissue inside the beating heart (e.g., leaflet tissue). This provides for accurate verification of placement of the interventional instrument. In addition, the system includes a grasping mechanism, which allows the practitioner to hold tissue in position prior to placing the interventional instrument.

Various self-cinching suture anchors, self-cinching suture anchor systems, and methods of use are provided. In one exemplary embodiment, a suture anchor is provided that includes an outer member and an inner member configured to be received within the outer member. The inner and outer members can define a gap that allows a suture to be movably disposed within the outer member, e.g., within the gap, when the inner member is disposed within the outer member. The inner member can be configured to be secured within the outer member by a knot of the suture having a diameter greater than a width of the gap so as to fix the inner member within the outer member, while still allowing uni-directional tensioning of the suture.

A knotless anchor for attachment of tissue to bone includes a rigid anchor body and a suture extending there from. The suture is hollow and includes a fixed limb portion secured to the rigid anchor body. A soft suture tunnel extends in a longitudinal direction through the fixed limb portion of the suture. A free suture limb is passed through the tissue, back to the anchor, and through the soft suture tunnel, thereby creating a closable suture loop around the tissue. Tension applied to the free suture limb closes the suture loop, and approximates the tissue to the anchor body. When the anchor is deployed in a bone hole, external features of the anchor body grip the walls of the bone hole and simultaneously compress the suture, thereby preventing tissue pull-out. Anchor assemblies and methods of tissue fixation are also disclosed.

Disclosed are methods, systems, and devices for the endovascular repair of cardiac valves, particularly the atrioventricular valves which inhibit back flow of blood from a heart ventricle during contraction. The procedures described herein can be performed with interventional tools, guides and supporting catheters and other equipment introduced to the heart chambers from the patient's arterial or venous vasculature remote from the heart. The interventional tools and other equipment may be introduced percutaneously or may be introduced via a surgical cut down, and then advanced from the remote access site through the vasculature until they reach the heart.

A multiple drive interference screw device with a head having multiple insertion features. The screw component has a tubular body with a first end and a closed second end, and the head is positioned at the first end and configured to engage with a driver to advance the screw into the bone A penetrating tip is positioned at the second end. The head of the screw component has at least three insertion features, such as a hex shaped insertion feature around the major diameter of the head and a hexalobe shaped insertion feature within the hex shaped insertion feature, and a sprocket shaped insertion feature positioned exterior to the hex shaped insertion feature.

A compression screw comprising a threaded shaft and a head associated with the proximal end of the shaft. The head has a plurality of outwardly extending projections spaced from one another so as to define a plurality of recesses there between for receiving a screw drive in such a way that rotational force may be transferred from the screw drive to the screw. The projections of the head may be provided with suture fixation holes or a suture coupling may be positioned over the shaft so as to extend between the projections of the head.

Apparatus for securing an object to bone, the apparatus comprising an anchor comprising a body comprising a passageway; and a movable element comprising a deformable portion; wherein the deformable portion is configured so that, (i) at a first level of force, the deformable portion restricts proximal movement of the movable element, and (ii) at a second, greater level of force, the deformable portion deforms and permits proximal movement of the movable element.

An anchoring system includes an anchor including an anchor body and a distal member located at a distal end of the anchor body, the distal member having a suture receiving aperture; and an implant delivery device, comprising: a cannulated outer shaft, the cannulated outer shaft configured to engage a proximal end of the anchor body for driving the anchor into a bore; and an inner shaft slidably received in the cannulated outer shaft, wherein a distal end of the inner shaft is extendable distally beyond a distal end section of the cannulated outer shaft such that, when the cannulated outer shaft is engaging the proximal end of the anchor body, the distal end of the inner shaft is extendable through the anchor body to a distance beyond the distal end of the anchor body to engage a suture located within the suture receiving aperture, wherein the anchoring system is configured such that the suture can be tensioned at a location within the bore distal from the anchor body before the anchor body is implanted within the bore.

A suture anchor method including a suture anchor and a suture anchor drive. The suture anchor is positionable on a rod of the suture anchor drive. The rod defines an awl for forming a hole in a bone. The suture anchor drive further has an impactor for moving the suture anchor along the rod between a retracted position and an advanced position so as to implant the suture anchor in the bone with the awl positioned in the bone.