Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

This disclosure enables various threading devices (e.g., suturing devices) that can sequentially send a plurality of carriers (e.g., needle caps, sleeves) to an object (e.g., animate, inanimate, human tissue, organ tissue, heart tissue) or sequentially receive a plurality of carriers (e.g., needle caps, sleeves) from an object (e.g., animate, inanimate, human tissue, organ tissue, heart tissue). For example, some threading devices can sequentially send some carriers in a relatively rapid succession or some threading devices can sequentially receive some carriers in a relatively rapid succession.

A suturing kit includes a suture and a suture holder for holding the suture. The suture has a first end and a second, opposite, end. The suture holder includes an elongated wall defining a suture receiving passage that is elongated along a longitudinal axis and terminates at a suture exit opening. The suture receiving passage has a width at least twice the diameter of the suture and receives the suture such that the suture is folded over forming a half loop section spaced from the suture exit opening. A first second of the suture extends from the half loop section toward the first end and a second section of the suture extends from the half loop section towards the second end. The first section and the second section of the suture within the suture receiving passage are aligned parallel to the longitudinal axis.

A suturing device includes a curved needle, a suture, an elongate body, an actuator and a curved needle holder. The suture connects with the curved needle. The actuator interacts with the elongate body and is operable between a first operating position and a second operating position. The curved needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The curved needle holder includes a distal end section having a distal-most tip. The curved needle holder includes an inner surface defining a needle passage for holding the needle and a distal opening. The curved needle has a curved needle radius and the curved needle passage has a curved needle passage radius that is different than the curved needle radius and the curved needle frictionally engages the inner surface when the needle is in a retracted position.

A suturing device includes a curved needle, a suture, an elongate body, an actuator and a curved needle holder. The suture connects with the curved needle. The actuator is operable between a first operating position and a second operating position. The curved needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The curved needle holder includes a distal end section having a distal-most tip. The curved needle holder defines a curved needle passage and a distal opening. Movement of the actuator from the first operating position toward the second operating position moves the curved needle with respect to the curved needle holder toward a released condition. The distal end section is configured to allow the curved needle to release from the curved needle holder at a location offset from the distal-most tip.

Apparatus, systems, and methods are provided for repairing heart valves through percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves via a trans-apical approach to accessing the heart. A guiding sheath may be introduced into a ventricle of the heart through an access site at an apex of the heart. A distal end of the guiding sheath can be positioned retrograde through the target valve. An annuloplasty ring arranged in a compressed delivery geometry is advanced through the guiding sheath and into a distal portion of the guiding sheath positioned within the atrium of the heart. The distal end of the guiding sheath is retracted, thereby exposing the annuloplasty ring. The annuloplasty ring may be expanded from the delivery geometry to an operable geometry. Anchors on the annuloplasty ring may be deployed to press into and engage tissue of the annulus of the target valve.

Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

A knot delivery device for securing a suture comprises an elongated body having a proximal end and a distal end, a pre-configured knot disposed at the distal end of the elongated body, a suture snare having a snare configured to capture suture material, wherein the snare extends through the pre-configured knot and a suture locker secured to one end of material forming the pre-configured knot, wherein tension applied to the suture locker tightens the pre-configured knot.

A suture-based vessel closure device can perform the dilation of an arteriotomy puncture and does not require previous dilation of the arteriotomy puncture by a separate device or by a procedural sheath dilator. The suture-based vessel closure device can place one or more sutures across the vessel access site such that, when the suture ends are tied off after sheath removal, the stitch or stitches provide hemostasis to the access site.

A knot pushing and suture-cutting device is disclosed including a handle having a multi-positional control and an inner shaft and outer tube extending from the handle. The inner shaft and outer tube both comprise slots and the outer tube is both axially and rotationally moveable relative to the inner shaft, to move the inner shaft and outer tube slots relative to each other. In a first configuration, the inner shaft and outer tube slots are aligned and configured to receive a suture therein. In a second configuration, the slots are configured to lock the suture within a lumen of the inner shaft. In a third configuration a cutting edge on the outer slot is configured to cut the suture.