A suture instrument comprising an elongated outer sleeve (3) and a cannula (9) terminating in a distal piercing tip (12) is slideable within a cannula bore (7) extending through the outer sleeve (3). A plurality of sutures (15), are located in a suture bore (14) extending longitudinally through the cannula (9). Each suture (15) comprises a suture thread extending between a pair of anchor bars (20), and a cinch clip (24), which is located on a loop (22) of the suture thread (7) formed between the anchor bars (20), and is slideable along the loop (22) for reducing the effective length of the suture thread (17) between the anchor bars (20). The anchor bars (20) and the cinch clips (24) of the sutures (15) are aligned end-to-end sequentially along the suture bore (14) of the cannula (9) with the cinch clip (24) of each suture (15) located between the anchor bars (20) thereof. A pusher rod (35) slideable in the suture bore (14) is operable by a linear actuator for sequentially urging the anchor bars (20) and the cinch clip (24) of each suture (15) from the suture bore (14) through the distal piercing tip (12) of the cannula (9).

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

A method can comprise advancing a suction cup at a distal end of a suction catheter into a heart chamber, contacting the suction cup to a heart valve leaflet, and partially axially collapsing the suction cup while applying a negative pressure through the suction catheter and the suction cup and contacting the suction cup to the heart valve leaflet.

The present disclosure relates to instruments, implant systems, and methods for joining bone and/or tissue portions. The instrument includes a handle portion; an inserter portion comprising an insertion portion and a tip portion; a guide portion comprising a medial end component and a distal end component, the guide portion extending from a distal end portion of the handle portion to a bone engagement end of the inserter portion; a passageway extending through the inserter portion from the distal end of the handle portion to the bone engagement end of the inserter portion; and a hole that extends from an exterior surface of the handle portion and the guide portion to the passageway, wherein the insertion portion and the tip portion of the inserter portion are positioned past the distal end component of the guide portion when the handle portion, the inserter portion, and the guide portion are mated.

Integratable treatment devices, assemblies including a treatment device, at least one anchor, and a tether coupled thereto, and various methods and devices for inserting such devices and assemblies are disclosed herein. The treatment devices can be made of an integratable material that is not fully bioresorbable but promotes native tissue growth in and around the material. Certain methods involve first inserting at least one anchor and then advancing a treatment device via a tether coupled to the at least one anchor. Further various insertion devices that can be used to implant any of the treatment devices herein using any of the methods herein are disclosed.

A valve prosthesis and methods for implanting the prosthesis are provided. The prosthesis generally includes a self-expanding frame and two or more engagement arms. A valve prosthesis is sutured to the self-expanding frame. Each engagement arm corresponds to a native mitral valve leaflet. At least one engagement arm immobilizes the native leaflets, and holds the native leaflets close to the main frame. The prosthetic mitral valve frame also includes two or more anchor attachment points. Each anchor attachment point is attached to one or more anchors that help attach the valve prosthesis to the heart.

The invention relates in some aspects to a device for use in anchoring an implant, including anchors, sutures, implants, clips, tools, lassos, and methods of anchoring among other methods. Anchors as disclosed herein could be utilized to secure a coaptation assistance device, an annuloplasty ring, an artificial valve, cardiac patch, sensor, pacemaker, or other implants. The implant could be a mitral valve ring or artificial mitral valve in some embodiments.

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.

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.

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.