The present disclosure relates to an anchor. The anchor includes a suture bridge having a proximal end and distal end. The distal end of the suture bridge has a thickness greater than a thickness of the proximal end of the suture bridge. At least two ribs extend from the proximal end of the suture bridge to a proximal end of the anchor. At least one open helical coil wraps around the at least two ribs and extends, substantially, from the proximal end of the suture bridge to the proximal end of the anchor. The at least one open helical coil defines an internal volume communicating with a region exterior to the anchor through apertures between turns of the at least one open helical coil. The at least two ribs are engagable with a grooved shaft of a driver.

A valve annulus repair system joins anchors at one or both of their proximal and distal ends to construct an implant to reshape the annulus. A removable frame may be used to position the anchors proximate to the annulus and to adjust the shape of the annulus. The frame may support the anchors during deployment of the system, release the anchors during construction of the implant, adjust the shape of the implant (and concomitantly the shape of the reconstructed valve) during an adjustment/cinching process, retain the adjusted shape of the valve annulus while relative anchor positions are secured, and release the anchors to enable the frame to be removed from the deployment site following implant construction. With such a system, a low-profile, flexile annular valve implant with reduced the risks of migration, fracture, embolism and thrombus may be provided.

The disclosure provides apparatus and methods of use pertaining to syndesmosis reinforcement. Embodiments include a clamp having two jaws that extend toward each other to clamp two bone portions therebetween. The clamp may include an angle gauge and an adjustment mechanism having a force gauge that combine to enable the compression of the two bone portions in an optimal direction or angle and at an optimal, measurable compression force. Embodiments also include a tension instrument configured to knotlessly lock a flexible strand construct between two anchors at the same optimal direction and tension applied by the clamp. Further embodiments include an exemplary syndesmosis reinforcement procedure that employs the clamp and the tension instrument to construct a ligament reinforcement construct that achieves optimal anatomic positioning in both directional alignment and the reduction force applied by the construct. Other embodiments are disclosed.

A method using a guide to assist in insertion of a helicoidal member in a target biological tissue. The method includes abutting a substantially longitudinally extending portion of the guide against a target tissue exposed surface with the helicoidal member mounted thereto so that at least a portion of the guide is inserted in a helicoidal member passageway substantially parallel to a helicoidal member longitudinal axis of the helicoidal member; adhering the substantially longitudinally extending portion of the guide to the target tissue exposed surface with the helicoidal member longitudinal axis substantially parallel to the target tissue exposed surface; and advancing the helicoidal member in the target biological tissue in a substantially helicoidal movement with the guide remaining substantially fixed relative to the target biological tissue.

Suture anchors having specialized cortical and cancellous bone-engaging segments with optimized thread patterns to enhance mechanical fixation to cortical and cancellous bone tissue. This is accomplished by providing multiple (e.g., two) starts of fine helical threads in the cortical bone-engaging segment and coarse helical threads with fewer starts (e.g., one start), and greater spacing, height, and depth in the cancellous bone-engaging segment. The threaded anchor body includes a central bore, with a socket at a proximal opening and a suture-attachment structural member therein. The bore only extends through the cortical bone-engaging segment but not the cancellous bone-engaging segment. This permits the cancellous bone-engaging segment to have a substantially reduced root diameter, which substantially increases the height and depth, and therefore the mechanical bite, of the cancellous bone-engaging threads.

A method is described, for use with a native valve of a heart of a subject, the valve being disposed between an atrium and a ventricle of the heart. A first radiopaque marker and a second radiopaque marker are percutaneously advanced to the heart. The first radiopaque marker is placed against a tissue site in the ventricle. The second radiopaque marker is placed against a component of the valve. A distance is fluoroscopically measured between the first radiopaque marker at the tissue site, and the second radiopaque marker at the component. At least one of the radiopaque markers is then withdrawn from the heart. Other embodiments are also described.

The disclosure provides systems and related methods for delivering a prosthesis to a target location. Various embodiments of useful valve prostheses are also disclosed.

A system for implanting an anchor into bone, the system comprising a curved cannulated guide for percutaneous insertion, having a proximal end and a distal end; a flexible drill insertable through the curved guide from the proximal end to the distal end, the flexible drill having a shaft having a flexible portion; and a flexible inserter for inserting a suture anchor into a bore at the anatomical site formed by the flexible drill, the flexible inserter having a shaft having a flexible portion, wherein the flexible portions of both the flexible drill and flexible inserter include a series of discrete, interlocking segments.

Systems and apparatuses herein include a longitudinal member having opposite first and second end portions, a tension of the longitudinal member being adjustable to repair an atrioventricular valve of the patient. A delivery tool can be configured to couple the first end portion of the longitudinal member to a first portion of heart tissue, couple the second end portion of the longitudinal member to the leaflet, adjust tension of the longitudinal member, assume a first diameter at a portion of the delivery tool that passes between the leaflets of the atrioventricular valve, during coupling of the first end portion of the longitudinal member to the first portion of heart tissue, and assume a second diameter that is smaller than the first diameter, at the portion of the delivery tool that passes between the leaflets of the atrioventricular valve, during adjusting of the tension of the longitudinal member.

Devices and methods for securing a tissue anchor in tissue of a patient, in particular to ensure proper deployment of a cardiac tissue anchor by regulating the force or pressure of a deployment tool against the tissue. One way to ensure proper deployment force is to visualize the distal end of the tissue anchoring catheter from outside the body using a display for an imaging sensor, where the distal end of the catheter changes configuration when it is pressed against the tissue. Another method involves automatically regulating the pressure applied to the tissue prior to deployment of the tissue anchor, which may also be used in conjunction with visualization. Several safety locks to prevent deployment of the tissue anchor prior to establishment of the proper pressure are disclosed, which again may be used with visualization and/or an automated pressure regulator.