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.

Implants, implant systems, and methods for treatment of mitral valve regurgitation and other valve diseases generally include a coaptation assist body which remains within the blood flow path as the leaflets of the valve move, the valve bodies often being relatively thin, elongate (along the blood flow path), and/or conformable structures which extend laterally from commissure to commissure, allowing the native leaflets to engage and seal against the large, opposed surfaces on either side of the valve body during the heart cycle phase when the ventricle contracts to empty that chamber of blood, and allows blood to pass around the valve body so that blood flows from the atrium to the ventricle during the filling phase of the heart cycle. Separate deployment of independent anchors near each of the commissures may facilitate positioning and support of an exemplary triangular valve body, with a third anchor being deployed in the ventricle. An outer surface of the valve body may accommodate tissue ingrowth or endothelialization, while a fluid-absorbing matrix can swell after introduction into the heart. The valve body shape may be selected after an anchor has been deployed, and catheter-based deployment systems may have a desirable low profile.

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.

Described herein are reusable surgical needles having a resiliently collapsible rear loop that captures a suture as it is passed through an object and resiliently expands upon exiting the object to release the suture. Also described are suture spool assemblies that include a rigid housing and a rotatable spool of suture material suspended within the housing so that a plurality of sutures can be dispensed from the assembly in succession during a surgery. Also described are annular pledgets having diametrical dimensions similar to an outer ring of a cardiac implant such that a single annular pledget can be used with a plurality of sutures that secure the cardiac implant to native tissue around the perimeter of the cardiac implant. Related methods of suturing cardiac implants are also disclosed.

A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device including a flexible portion that is suited to access target anatomy. The flexibility of an elongate portion of the delivery device can be varied. Additionally, the delivery device can include structure that maintains the positioning of the delivery device in patient anatomy.

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.

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.

The invention comprises a system, method, and apparatus for securing two ends of a ruptured or partially ruptured tendon in the hand or wrist during a repair, recession, or revision procedure. During this tenorrhaphy, anchoring material is inserted into the proximal ruptured surface of the tendon by an apparatus comprising multiple needles of at least two different types. Connecting material spans the site of tenorrhaphy of a ruptured tendon, or a multiplicity of ruptured tendons. In some embodiments, interlocking patterns of loop and helical suture are inserted by straight and helical needles, respectively.

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.