A ringless web is configured to repair heart valve function in patients suffering from degenerative mitral valve regurgitation (DMR) or functional mitral valve regurgitation (FMR). In accordance with various embodiments, a ringless web can be anchored at one or more locations below the valve plane in the ventricle, such as at a papillary muscle, and one or more locations above the valve plane, such as in the valve annulus. A tensioning mechanism connecting the ringless web to one or more of the anchors can be used to adjust a tension of the web such that web restrains the leaflet to prevent prolapse by restricting leaflet motion to the coaptation zone and/or promotes natural coaptation of the valve leaflets.

The invention relates in some aspects to a device for use in anchoring an implant, including anchors, sutures, implants, clips, tools, lassos, and methods of anchoring among other methods. Anchors as disclosed herein could be utilized to secure a coaptation assistance device, an annuloplasty ring, an artificial valve, cardiac patch, sensor, pacemaker, or other implants. The implant could be a mitral valve ring or artificial mitral valve in some embodiments.

Provided are fastening nail, fastening nail implanting apparatus and medical instrument, wherein the fastening nail includes a nail seat and a spiral part, wherein front end of the spiral part is formed as a tip, rear end of the spiral part is fixedly connected to front end of the nail seat, and a first positioning part is provided on an end surface of rear end of the nail seat. The fastening nail implanting apparatus implants the fastening nail into a human body and includes a base, a conveying cable and an anchoring handle, wherein rear end of the conveying cable is connected to the anchoring handle, and front end of the conveying cable is provided with a second positioning part; and the anchoring handle is installed on the base, and drives the conveying cable to rotate or release the fastening nail under first working condition or second working condition.

A tissue-engaging element has a distal portion configured to engage a portion of tissue of the heart. A guide member is reversibly coupled to the tissue-engaging element. An elongate implant has a distal end and a proximal end, at least the distal end being slidably coupled to the guide member. A tool is slidable along the guide member distally toward the tissue-engaging element while (i) the tool is coupled to at least the distal end of the elongate implant, and (ii) the guide member is coupled to the tissue-engaging element, such that sliding of the tool along the guide member distally toward the tissue-engaging element while (i) the tool is coupled to at least the distal end of the elongate implant, and (ii) the guide member is coupled to the tissue-engaging element, slides at least the distal end of the elongate implant toward the tissue-engaging element.

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 coupling system includes an applicator tool and an attachment ring mounted on the applicator tool. Clips are contained within the applicator tool and are deployed through the attachment ring in order to anchor the attachment ring to biological tissue. When deployed, tips of the clips follow a curved trajectory through an annular cuff of the attachment ring and through the underlying tissue. The tips loop back out of the tissue and to a location where they are later trapped or clamped by the attachment ring. While the tips are trapped or clamped, the applicator tool cinches the clips by pulling rear segments of the clips. Thereafter, the applicator tool disconnects from the attachment ring which remains anchored to the tissue and serves as a coupling for a cannula. The cannula can have movable lock members that secure it to the attachment ring.

The present invention describes systems and methods for treating mitral valve regurgitation. The treatment includes a systems and method of modifying the mitral valve by attaching a device to each leaflet and pulling them toward each other to stop mitral valve regurgitation.

Suture anchors are disclosed having suture locking features able to lock multiple suture ends extending from a body tissue, such as from a bone tunnel, with a single device.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium, through the mitral valve, and into the left ventricle. A ventricular anchor is deployed from the catheter and into a wall of the left ventricle, leaving a ventricular suture attached to the ventricular anchor and extending proximally through the catheter. A leaflet anchor is deployed to secure a mitral valve leaflet to a leaflet suture, with the leaflet suture extending proximally through the catheter. The leaflet suture is secured to the ventricular suture to limit a range of travel of the leaflet in the direction of the left atrium. Also disclosed is an assembled in situ mitral valve leaflet restraint, having a neo papillary muscle and a neo chordae tendinea.

Methods and systems are provided for securing tissue to bone. A surgical system can include a driver device, an elongate shaft receivable within the driver device and having a dilator feature at its distal end, and a capture suture extending through the shaft such that the capture suture's terminal end portions extend to a more proximal position on the driver and the capture suture forms a loop that extends through an opening formed through a side of the shaft. The loop is configured to receive at least one retention suture therethrough and can be tightened by pulling the capture suture's terminal ends, thereby coupling the retention suture with the suture anchor. Once the shaft is inserted into bone and the loop with the retention suture is closed, the suture anchor is driven distally towards the dilator features and into the bone to secure the retaining suture in the bone.