According to one embodiment, a protective device for use in congestive heart failure treatments, and other treatments, includes a control mechanism, an elongate shaft, and a protective plate. The control mechanism is coupled with a proximal end of the elongate shaft and the protective plate is pivotably coupled with a distal end of the elongate shaft. The elongate shaft enables the protective plate to be inserted within a body and navigated distally of a heart wall. The protective plate has a relatively wide and thin body portion and is pivotable relative to the elongate shaft by operation of the control mechanism. Pivoting and/or navigating of the protective plate within the body allows the protective plate to be positioned adjacent the heart wall to shield body organs or tissue surrounding the heart wall from being damaged by surgical instruments inserted through the heart wall.

Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

Devices and methods to attach soft tissue to bone include, for example, forming a transosseous bone tunnel, and forming a suture construct securing soft tissue to the bone wherein the suture construct extends from the soft tissue to the first opening, through the first opening, through the bone tunnel, through the second opening, and outside of the bone tunnel to the soft tissue.

A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. A medical device is used to secure the fastener to the elongate fastening member. The medical device includes a tensioning mechanism for tensioning the elongate fastening member. As crimping mechanism is used to secure the fastener to the elongated member, where a cutting mechanism cut the excess portion of the elongated member.

A device for treating a tissue defect including a grasper including a pair of arms movable between a tissue receiving configuration and a tissue gripping configuration, a needle extending longitudinally from a proximal end to a distal end and including a first lumen extending longitudinally therethrough, the needle slidably received between the arms so that the needle is movable between a non-extended configuration, in which the distal end of the needle is proximal the distal ends of the arms, and an extended configuration, in which the distal end of the needle is distal of the distal end of the arms, and a first suture element slidably housed within the first channel and deployable therefrom to be anchored in a first target tissue into which it is inserted, the first suture element including a first cross member attached to a distal end of a first suture.

Improved methods and apparatus to secure a urethral sling to pubic bone in a sub-urethral location to support the urethra and alleviate incontinence are disclosed. The urethral sling is preferably formed of a flexible sheet material extending between opposed first and second sling ends and bounded by opposed first and second sling sides. The urethral sling is selectively tensioned in a central portion intermediate the first and second sling ends and/or in one or both of end portions bracketing the central portion. In one embodiment, pre-positioned plicating lines in the central portion are selectively drawn and tied to slacken the central portion and tension the end portions. In further embodiments, bone anchor lines passed through locations displaced from the sling ends are drawn and fixed to tension the central portion between the displaced locations and slacken the end portions.

An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the flexible fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

According to one embodiment, a protective device for use in congestive heart failure treatments, and other treatments, includes a control mechanism, an elongate shaft, and a protective plate. The control mechanism is coupled with a proximal end of the elongate shaft and the protective plate is pivotably coupled with a distal end of the elongate shaft. The elongate shaft enables the protective plate to be inserted within a body and navigated distally of a heart wall. The protective plate has a relatively wide and thin body portion and is pivotable relative to the elongate shaft by operation of the control mechanism. Pivoting and/or navigating of the protective plate within the body allows the protective plate to be positioned adjacent the heart wall to shield body organs or tissue surrounding the heart wall from being damaged by surgical instruments inserted through the heart wall.

A suture having a first end for penetrating tissue, an elongated suture body having a periphery; a plurality of retainers on the periphery, and a second end having a variable loop of variable circumference, wherein the variable loop includes a fixed loop slidably engaging the elongated body for slidingly varying the circumference of the variable loop, and wherein the first end may pass through the variable loop to secure tissue as an anchor, the anchor preventing movement of the suture in the direction of deployment of the first end.

Catheter-based devices and methods for endoluminally accessing and occluding hollow anatomical structures are disclosed. Occlusion clips are contained in one or more needles that pierce opposing walls of the anatomical structure to deploy the clips externally of the structure. The clips then are drawn together to press the opposing anatomical walls together.