A closure device system for sealing a percutaneous puncture in a vessel wall can comprise a toggle configured to engage an interior surface of the vessel wall, a plug configured to engage an exterior surface of the vessel wall, and a suture that extends through the plug and through the toggle along at least a first direction so as to couple the toggle to the plug. The system can further comprise a tube that extends through the plug and through the toggle along the first direction such that a distal end of the tube is disposed distally to the toggle. The tube can define a guidewire lumen that extends therethrough along the first direction. And the guidewire lumen can be configured to receive a guidewire that protrudes from the vessel wall such that the plug, toggle, and tube are slidable along the guidewire toward the vessel wall.

A method includes passing a first flexible strand through a tissue section by a first needle coupled to a driver. The driver includes a longitudinal body defining an opening at a distal end. The first needle is positioned in the opening. A first hole is formed through a bone. The first flexible strand is passed through the first hole using a strand retriever. The strand retriever includes a body having a first longitudinal tube extending therefrom and a first snare slideably deployable from the first longitudinal tube. The first longitudinal tube is positioned from a first side of the bone in the first hole and the first snare is deployed on a second side of the bone. The first snare passes the first flexible strand through the first hole in the bone. The tissue section is secured to the bone using the first flexible strand.

An improvement to devices and methods for suturing tissue in various applications, such as percutaneous closure of arterial and venous puncture sites and the like, providing a self-locking or self-securing suture that does not require manual knot-tying to hold in apposition the tissue of the vessel wall on opposite sides of the puncture.

An assembly and method are provided for incorporation into suture anchor designs to facilitate the locking of a slidable working suture after it has been tensioned. The assembly can be utilized on multiple anchors in a pre-strung chain on a single working suture to create continuous, individually tensioned suture bridges between anchors in series, without knot tying. Further, the bridges are independently locked with selected tension for the particular application. An anchor body having at least one suture receiving passage therethrough is threaded with a working suture wherein the working suture flosses through the passage when tension is applied to the working suture. A locking cord extends through a second passage through the anchor body, the locking cord having a collapsible loop extending out the second passage and encircling a portion of the working suture, wherein collapsing the loop locks the working suture after tensioning.

A closure device system for sealing a percutaneous puncture in a vessel wall can include a toggle configured to engage an interior surface of the vessel wall, a plug configured to engage an exterior surface of the vessel wall, and a suture that extends through the plug and through the toggle along at least a first direction so as to couple the toggle to the plug. The system can further include a tube that extends through the plug and through the toggle along the first direction such that a distal end of the tube is disposed distally to the toggle. The tube can define a guidewire lumen that extends therethrough along the first direction. And the guidewire lumen can be configured to receive a guidewire that protrudes from the vessel wall such that the plug, toggle, and tube are slidable along the guidewire toward the vessel wall.

A heart valve prosthesis is provided that includes a first member and a second member. The first member comprises a first central portion to be disposed adjacent to a line of coaptation on a first side of two adjacent heart leaflets and peripheral portions to be placed into direct contact with the two adjacent heart leaflets. The second member is separate from or can be separable from the first member, for example during delivery. The second member has a central portion and peripheral portions configured to be placed into direct contact with a second side of the two adjacent heart leaflets.

A knot pusher for quickly loading suture without needing to thread a distal end. The knot pusher includes an actuator housing having an actuator moveable between an open position and a closed position and an elongated tube extending from the actuator housing. The knot pusher includes at least two slots, a gate slot extending through the elongated tube and a suture loading slot extending through the elongated tube and traversing the gate slot. A moveable gate cross bar is connected to the actuator such that the gate cross bar moves with the actuator between the open position and the closed position. When the actuator is in the closed position, the gate cross bar extends through at least a portion of the suture loading slot. The knot pusher may also include an ergonomic loop handle that enforces the correct orientation of the knot pusher for use.

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 method includes passing a first flexible strand through a tissue section by a first needle coupled to a driver. The driver includes a longitudinal body defining an opening at a distal end. The first needle is positioned in the opening. A first hole is formed through a bone. The first flexible strand is passed through the first hole using a strand retriever. The strand retriever includes a body having a first longitudinal tube extending therefrom and a first snare slideably deployable from the first longitudinal tube. The first longitudinal tube is positioned from a first side of the bone in the first hole and the first snare is deployed on a second side of the bone. The first snare passes the first flexible strand through the first hole in the bone. The tissue section is secured to the bone using the first flexible strand.

A tissue repair assembly is disclosed, including a soft anchor body and at 5 least a first suture operably coupled to the anchor body. Tensioning on first and/or second ends of first suture may deploy the anchor body to a second configuration, in which the anchor body is axially compressed and radially extended. The tissue repair assembly may also include a means to cinch around a portion of a first and/or second suture and knotlessly lock the tissue repair assembly. Some embodiments 10 may include a pre-formed knot. In some embodiments, the preformed knot may be a nail knot, provided wrapped around an insertion instrument and configured to receive and cinch around a suture extending therethrough.