Abstract: One embodiment is directed to a system for closing a wound created across a portion of a tissue structure, comprising a suture member having proximal and distal ends; an anchor member coupled to the distal end of the suture member; a tension retainer assembly releasably coupleable to the suture member; and a suture buttress movably intercoupled to the suture member between the anchor member and the tension retainer and configured to minimize direct sliding contact between the suture member and the tissue structure portion around the location of the suture buttress.

Abstract: One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising: a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein the proximal end of the suture member extends proximally beyond the deployed suture pattern into a local suture length storage reservoir coupled to the delivery member, the reservoir containing an additional length of suture and being configured such that upon rotation of the delivery member in the first direction, the anchor member pulls along the distal portion of the suture member c

Abstract: One embodiment is directed to a system for closing a wound created at least partially across a tissue structure wall, comprising: a helical needle; a suture member coupled to the helical needle and configured to be pulled along a helical pattern with helical movement of the helical needle; an outer delivery member rotatably coupled to the helical needle; a drive shaft axially movably coupled to the outer delivery member; and a plurality of suture guide struts projecting distally from the outer delivery member; wherein upon helical insertion of the helical needle relative to the outer delivery member, the helical needle is advanced such that it becomes disposed around the guide struts, such that the guide struts prevent radial migration of the suture as it is helically wound into the tissue structure.

Abstract: One embodiment is directed to a method for providing surgical access across a wall of a tissue structure, comprising: installing a guiding member into the wall of the tissue structure to a desired guiding depth; using the installed guiding member as a positional guide, advancing a helical member into the wall of the tissue to a desired helical member depth, the helical member comprising a helical member distal end removably coupled to an anchor member which is coupled to a distal end of a suture member, such that advancing the helical member into the wall causes the anchor member to be advanced into the wall and to pull a distal portion of the suture member along with the anchor member into the wall to substantially encapsulate a number of helical loops of suture member that is greater than about 1 loop and less than about 3 loops; withdrawing the helical member from the wall of the tissue structure, leaving the anchor member in a deployed configuration decoupled from the helical member and coupled to at leas

Abstract: Embodiments are described for creating and closing tissue access ports or defects, such as transapical access ports, which involve placement of an elongate prosthesis in a helical configuration across the tissue structure site to be crossed, and confirmation that such helical suture configuration is positioned appropriately, before further interventional steps. A plug member may be included to assist with closure of the ports of defects. The elongate prosthesis and plug member may comprise bioresorbable materials.

Abstract: One embodiment is directed to a system for closing a wound created across a portion of a tissue structure, comprising a suture member having proximal and distal ends; an anchor member coupled to the distal end of the suture member; a tension retainer assembly releasably coupleable to the suture member; and a suture buttress movably intercoupled to the suture member between the anchor member and the tension retainer and configured to minimize direct sliding contact between the suture member and the tissue structure portion around the location of the suture buttress. Other configurations are disclosed for utilizing suture buttress material, also termed tubular braided pledgets, for various suturing, closure, and stabilization configurations.

Abstract: One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein upon rotation of the delivery member in a first direction, the first helical member and coupled anchor member are advanced across at least a portion of the wall of the tissue structure, pulling along the distal portion of the suture member in a deployed suture pattern which remains coupled to the anchor member, the deployed suture pattern being characterized in that it is substantially

Abstract: One embodiment is directed to a method for tensioning a suture member that crosses a portion of a wall of a tissue structure, comprising: advancing a distal portion of the suture member across at least a portion of a wall of the tissue structure; advancing a tensioning assembly, through which the suture member is threaded, toward the wall of the tissue structure, the tensioning assembly comprising: a tensioning member base having a tissue interface surface configured to engage a portion of the tissue structure when coupled to a suture member that may be threaded through the tensioning member base and into the tissue structure; a suture clamping member configured to be switched from a first mode, wherein a suture may be tensioned back and forth through a space defined at least in part by the clamping member, to a second mode, wherein a suture may only be tensioned in one direction relative to the suture clamping member; and a mode switching member movably coupled to the suture clamping member and configured to

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: One embodiment is directed to a method for tensioning a suture member that crosses a portion of a wall of a tissue structure, comprising: advancing a distal portion of the suture member across at least a portion of a wall of the tissue structure; advancing a tensioning assembly, through which the suture member is threaded, toward the wall of the tissue structure; manipulating a elongate compressive loading member to adjust the physical relationship between the tensioning assembly, suture member, and tissue structure wall by modulating the position of the tensioning member base relative to the suture member and tissue structure wall with the tensioning mode switching member in the first mode; and controllably switching the tensioning mode switching member to the second mode.

Abstract: One embodiment is directed to a method for advancing a needle into a tissue structure, comprising: advancing a distal end of a needle insertion assembly, the assembly comprising an insertion member coupled to a tissue interface indentor member and movably coupled to an elongate needle member, against a targeted tissue structure such that a distally protruding shape feature of the tissue interface indentor member engages one or more portions of the targeted tissue structure adjacent a distal tip of the elongate needle member at a position at which the elongate needle member distal tip is configured to be advanced through the insertion member and into the tissue structure, and locally changes an available angle of penetration between such portions and the distal tip of the elongate needle member; and inserting the elongate needle member relative to the insertion member and tissue interface indentor member.

Abstract: One embodiment is directed to a system for advancing a needle into a tissue structure, comprising: an elongate needle member having a tapered distal tip; an insertion member having proximal and distal ends, the distal end being coupled to the elongate needle member, and the proximal end being configured to be manipulated by an operator; and a tissue interface indentor member coupled to the insertion member and operatively coupled to the elongate needle member, the tissue interface indentor member comprising a distally protruding shape feature configured to contact one or more portions of the tissue structure adjacent to the distal tip of the elongate needle member and change an available angle of penetration between such portions and the distal tip of the elongate needle member as the distal tip is inserted into tissue structure.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: One embodiment is directed to a method for providing surgical access across a wall of a tissue structure, comprising: advancing a helical needle into the wall of the tissue structure such that the needle pulls an intercoupled suture member across the wall to form a deployed suture pattern, the deployed suture pattern being characterized in that: the portion of the suture member encapsulated by the wall of the tissue structure is substantially helical in formation and represents a number of helical loops that is greater than about one helical loop, and is less than about three helical loops; portions of the suture member on either side of the wall are in a slack configuration such that tension in the suture member arising from the encapsulated portion pulls in additional length from the slack configuration on either side of the wall to accommodate expansion of the substantially helical encapsulated portion.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: One embodiment is directed to a method for advancing a needle into a tissue structure, comprising: advancing a distal end of a needle insertion assembly, the assembly comprising an insertion member coupled to a tissue interface indentor member and movably coupled to an elongate needle member, against a targeted tissue structure such that a distally protruding shape feature of the tissue interface indentor member engages one or more portions of the targeted tissue structure adjacent a distal tip of the elongate needle member at a position at which the elongate needle member distal tip is configured to be advanced through the insertion member and into the tissue structure, and locally changes an available angle of penetration between such portions and the distal tip of the elongate needle member; and inserting the elongate needle member relative to the insertion member and tissue interface indentor member.

Abstract: One embodiment is directed to a system for advancing a needle into a tissue structure, comprising: an elongate needle member having a tapered distal tip; an insertion member having proximal and distal ends, the distal end being coupled to the elongate needle member, and the proximal end being configured to be manipulated by an operator; and a tissue interface indentor member coupled to the insertion member and operatively coupled to the elongate needle member, the tissue interface indentor member comprising a distally protruding shape feature configured to contact one or more portions of the tissue structure adjacent to the distal tip of the elongate needle member and change an available angle of penetration between such portions and the distal tip of the elongate needle member as the distal tip is inserted into tissue structure.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.