The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

A tissue anchor includes an elongated body having a proximal end and a distal end, and a barb mounted to the elongated body adjacent the proximal end for movement between a retracted position and an extended position in which the barb projects outwardly from the elongated body. An anchoring system includes an implantable device with a tissue contacting surface facing in a proximal direction, the tissue anchor having its distal end engageable with the implantable device and its proximal end adapted to project proximally beyond the tissue contacting surface to grip a living tissue, and a second resilient element that is mounted between the distal end of the anchor and the implantable device, the second resilient element being adapted to bias the anchor distally relative to the implantable device. Tooling and methods of insertion and removal are provided.

Described are pelvic implants (e.g., urinary incontinence sling, hammock, etc.) and method of implanting a pelvic implant that provide treatment for pelvic floor disorders such as incontinence, stress urinary incontinence, prolapse (e.g., cystocele, enterocele, rectocele, vault prolapse), fecal incontinence, and the like, wherein the implant and methods involve various features, such as the ability to adjust dimensions of an implant before, during, or after implantation.

The present disclosure provides an expandable fastener for orthopaedic applications and arranged for fastening when positioned in a bore hole in bone. The fastener comprises a body having an axis. The fastener further comprises an expansion portion moveable between a contracted configuration and an expanded configuration such that, in use, the expansion portion urges outwardly from the body towards the bone surrounding the bore hole. The fastener is arranged such that ingrowth of bone between the expansion portion and the body is substantially avoided when the expansion portion is in the expanded configuration.

Some materials used to make anchors for soft tissue repair, for example, have beneficial properties, including stiffness, bioabsorbability, and osteoconductivity. These materials, however, are not flexible and are challenging to make flexible wings out of for winged anchors. Wing flex is desirable for achieving high fixation strength in winged anchors. Accordingly, an anchor is provided having a hybrid structure including a core body made from a biocomposite, bioabsorbability, osteoconductivity or biocompatible non absorbable material and a wing assembly made from different and more flexible material. Examples of the hybrid anchor take advantage of properties of the different materials strategically placed. A no-hole-prep example of the hybrid anchor reduces the time to install the anchor. A modular example of the hybrid anchor provides a customizable anchoring solution to meet a variety of diverse clinical needs.

Apparatus and methods to reduce ventricular volume are disclosed. The device takes the form of a transventricular anchor, which presses a portion of the ventricular wall inward, thereby reducing the available volume of the ventricle. The anchor is deployed using a curved introducer that may be inserted into one ventricle, through the septum and into the opposite ventricle. Barbs or protrusions along the anchor body combined with a mechanical stop and a sealing member hold the device in place once deployed.

Disclosed are methods, systems, and devices for the endovascular repair of cardiac valves, particularly the atrioventricular valves which inhibit back flow of blood from a heart ventricle during contraction. The procedures described herein can be performed with interventional tools, guides and supporting catheters and other equipment introduced to the heart chambers from the patient's arterial or venous vasculature remote from the heart. The interventional tools and other equipment may be introduced percutaneously or may be introduced via a surgical cut down, and then advanced from the remote access site through the vasculature until they reach the heart.

A method is provided for reducing tricuspid valve regurgitation of a patient. The method includes implanting a first tissue anchor at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient, and implanting a second tissue anchor at a second implantation site in cardiac tissue of the patient opposite the first implantation site across the tricuspid valve. Using a spool that winds therewithin at least a portion of a longitudinal member that couples the first and the second tissue anchors together, tension is applied between the first and the second tissue anchors to alter the geometry of the tricuspid valve by rotating the spool.

A surgical device that is implantable to treat female urinary incontinence includes a support, a first suspending member connected to the support, a second suspending member connected to the support, a first anchor connected to the first suspending member, and a second anchor connected to the second suspending member. Microgrooves are formed in a surface of at least one of the first suspending member and the second suspending member.

Devices and methods are provided herein that generally involve suture anchors having one or more anti-backup features configured to resist or prevent backward movement of a suture that is pulled through the suture anchor. In some embodiments, the suture anchor can be configured to permit a suture to slide freely in one direction but resist or prevent suture movement in the opposite direction. For example, cleats can be rotatably mounted within the suture anchor, can project radially outward from an exterior sidewall of the suture anchor, or can project circumferentially from sidewalls of one or more channels formed in the suture anchor's exterior surface.