Apparatus and methods are described herein for use in the delivery of a prosthetic mitral valve. In some embodiments, an apparatus includes a tether fixer assembly configured to engage an outside surface of a heart to secure a prosthetic heart valve in position within the heart. The fixer assembly defines a lumen configured to receive therethrough a tether extending from the prosthetic valve and a movable portion. The fixer assembly is movable between a first configuration, in which the movable portion is disengaged with the tether, and a second configuration in which the movable portion is engaged with the tether. The fixer assembly can be disposed against an epicardial pad positioned on the outside surface of the heart when in the second configuration to secure the prosthetic valve, the epicardial pad and tether in a desired position within the heart.

An anchor assembly is configured to implant a cardiac anchor into a heart wall of a patient to anchor a suture configured to extend from a valve leaflet of the heart as an artificial chordae. The anchor assembly can include an anchor hub defining an open interior and a helical coil extending distally from the anchor hub and having a sharpened tip configured to embed the helical coil into the heart wall upon rotation of the helical coil. A spring can be disposed within the open interior of the anchor hub. Compressing the spring distally can create an open space within the open interior of the anchor hub for a suture extending through the anchor hub to slide freely and releasing compression on the spring can cause the spring to expand in a proximal direction to clamp the suture within the open interior of the anchor hub.

A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Suture passer systems for tissue suspension and tissue compression, and more particularly for tongue suspension, are described. The system can include at least a first elongate tubular body or shaft, a needle having a lateral bias carried by the elongate body, and a retrieval element operably connected to the elongate tubular body. The needle can have a substantially straight configuration when located within the elongate tubular body, and be configured to exit an opening at or near a distal end of the elongate tubular body and assume a laterally biased or curved shape to form a path through tissue. The needle is configured to carry a suture. The retrieval element can be configured to retrieve the suture carried by the needle after the needle has formed a curved or otherwise angled path through tissue. The system can also include one or more bone anchors to secure the suture loops. Methods of placing one or more suture loops into tissue, such as the base of the tongue, are also described.

Devices, systems, implants and methods for achieving ligament fixation are disclosed. An implant includes a head member and an anchor member coupled to the head member. The implant includes tension member that couples the head member to the anchor member. The head member and the anchor member include a cannulation that receives the tension member therein. The implant may include a coupling member positioned between and coupling the head member and the anchor member, the coupling member including a cannulation that receives the tension member therethrough. Insertion instruments for inserting an implant for ligament fixation are also disclosed. Methods of using an implant for achieving ligament fixation are also disclosed.

A syndesmosis system includes a bone plate and an anchor. The bone plate includes a body extending between first and second surfaces. The body defines a strand-locking hole extending from the first surface to the second surface. A first locking element and a second locking element each extend from a first side wall of the strand-locking hole to a second side wall of the strand-locking hole. Each of the first anchor and the second anchor extend transverse to a central axis of the anchor hole. The anchor includes a body defining a first wing and a second wing. The first and second wings are coupled at a distal end and are biased away from a longitudinal axis of the body. The first and second wings are configured to maintain the anchor in a fixed position when inserted into a hole formed in a bone.

Components and associated methods of manufacture or assembly and/or use for bone and joint stabilization devices or systems are described. The components include features for device introduction, attaching a distal anchoring foot or threaded screw to an elongate spring-type member, anchoring head features for stabilizing position of the elongate member when engaged within the head and/or digital or electronic methods for tensioning the subject devices.

Disclose herein are suture anchor constructs. The suture anchor constructs can include an anchor, a first suture, and a second suture. The anchor can include a post and a body. The body can define a central hole extending from a trailing end of the body along a central axis towards a leading end of the body. The first suture can have a first tail, a second tail, and a first intermediate potion located proximate the post. The second suture can have a third tail, a fourth tail, and a second intermediate portion secured to the post. The first, second, third, and fourth, tails can pass through the central hole.

A system includes a first tube, a sharp coil at a distal end of the first tube, a second tube displaceable within the first tube, and a sharp housing at a distal of the second tube for storing fasteners. The housing can be positioned at a first tissue, and the coil rotated to advance the coil into engagement with the first tissue. The first tube is retracted to retract the first tissue, and then a first fastener is deployed at the first tissue location. Then, without removing the system from the patient, the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second fastener at the second tissue location. A suture extends between the first and second fasteners, and tension is applied to the suture to draw the first and second tissues toward each other to reconfigure the tissue.

Syndesmosis fixation assemblies, systems, and methods thereof. A syndesmosis fixation assembly includes a suture retaining portion having a plurality of suture openings formed therein and a suture securing portion rotatably connected to the suture retaining portion. The suture securing portion is movable between a first position wherein a suture is moveable within the suture retaining portion and a second position wherein the suture is frictionally secured within the suture retaining portion. A bone insertion portion has a distal bone insertion end adapted for insertion into a bone, a proximal bone insertion end connected to the suture retaining portion, and a central longitudinal axis extending between the distal bone insertion end and the proximal bone insertion end.