A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

An exemplary tissue compression device for forming an anastomosis includes a first device portion having a first mating surface, a first base wall recessed from the first mating surface so as to define a first inner recess, and a first set of suture bores extending through the first base wall and opening to an outer periphery of the first device portion. A second device portion of the device has a second mating surface, a second base wall recessed from the second mating surface so as to define a second inner recess, and a second set of suture bores extending through the second base wall and opening to an outer periphery of the second device portion. The first and second device portions are configured to compress tissue positioned between the first and second mating surfaces.

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, and a fixation device releasably coupled to the delivery catheter. The fixation device includes a first arm moveable between a closed position and an open position, and a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each include a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.

The present invention provides methods and devices for grasping, and optional repositioning and fixation of the valve leaflets to treat cardiac valve regurgitation, particularly mitral valve regurgitation. Such grasping will typically be atraumatic providing a number of benefits. For example, atraumatic grasping may allow repositioning of the devices relative to the leaflets and repositioning of the leaflets themselves without damage to the leaflets. However, in some cases it may be necessary or desired to include grasping which pierces or otherwise permanently affects the leaflets. In some of these cases, the grasping step includes fixation.

A surgical suture and method of suturing is described. The surgical suture includes a pair of matched fastening elements connected by a length of suture. The fastening elements have interlocking components, allowing a surgeon to adjust the tightness of the suture. Fastening element holding devices are also provided to guide the use the surgical suture. The method includes placing the fastening elements in the holding devices, threading one or both of the fastening elements through the body of the patient, and securing the surgical suture, and removing the holding devices.

A surgical suturing apparatus includes an end effector including a jaw assembly and a needle assembly. The jaw assembly includes first and second jaws movable between open and closed positions. Each of the first and second jaws includes a tissue facing surface having an elongated rail and a longitudinal row of teeth. Each tooth of the longitudinal rows of teeth of the first and second jaws includes a needle channel extending therethrough. The elongated rails and the longitudinal rows of teeth of the first and second jaws are disposed in opposed relation relative to each other. The needle assembly includes a first needle, a second needle, and a suture coupled to the first and second needles. The first needle is slidable through the needle channels of the first jaw and the second needle is slidable through the needle channels of the second jaw.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A method and device for anchoring a length of self-retaining suture. The method of anchoring includes providing for an assembly having a length of self-retaining suture and a suture insertion device. The length of suture includes at least a portion of the length having a plurality of retainers thereon extending in a first direction. The insertion device has a length and a recess to receive a portion of the suture length. The method further includes placing a portion of the suture length in the recess and inserting the device into the body of a mammal until the recess reaches a predetermined location thereby forming an insertion pathway. The method further includes retrieving the insertion device from the body by moving the insertion device in a direction substantially opposed to the insertion pathway.

A cassette is disclosed for use in a prosthetic suturing device. The cassette has a base. The base has a pair of pivots, a pair of alignment tabs, and at least one retention latch. The cassette also has a cover coupled to the base. The cover has at least one retention latch. The cover also defines one or more ferrule holders. The cassette further has one or more needles guided by the base and the cover. A surgical suturing device is also disclosed for use with a cassette. The suturing device has a cassette receiver and one or more needle drivers, each needle driver having a needle receiver positioned within the cassette receiver.

Synthetic chord devices and methods for using the same for connecting tissues are provided. Aspects of the synthetic chord devices include a first flexible connector having first and second ends. Located at the first end is an attachment element that includes a piercing member coupled to a securing member, wherein the securing member transitions from a linear to a planar configuration upon separation of the piercing member from the attachment element. A reinforcing element is located at the second end. The devices and methods of the invention find use in a variety of applications, such as cardiac valve, e.g., mitral valve repair; or tissue closure.