Abstract: A suture system can comprise a first and a second curved double arm needle, and a needle docking device configured to maintain the first and the second curved double arm needles in alignment with and parallel to one another and at predetermined orientations relative to the needle docking device. The system can include a needle manipulating instrument having a distal portion configured to engage the first and the second curved double arm needles while the first and second curved double arm needles are in the needle docking device, and to maintain the needles in predetermined orientations.

Abstract: A method of suturing an opening in a target tissue can comprise stitching a first suture to a first pad, stitching the first pad to a first tissue area adjacent to the opening in the target tissue and stitching a second suture to the first pad. The method can include forming a first purse-string suture, using the first suture, along a first path in the target tissue around the opening using the first suture, and forming a second purse-string suture, using the second suture, along a second path in the target tissue surrounding the first purse-string suture.

Abstract: Disclosed herein are sutures (or cords) and methods for using sutures wherein the sutures comprise a material or a combination of materials configured to increase echogenicity of the sutures. In some examples, the sutures comprise echogenic materials incorporated into suture material (e.g., ePTFE). In some examples, the sutures comprise a combination of materials with abrupt and relatively large changes in density to increase reflections of ultrasound waves. The disclosed sutures enhance echogenicity to increase visibility of the sutures using ultrasound imaging technologies. Furthermore, disclosed herein are methods that utilize the disclosed sutures in valve repairs including implanting artificial cords, sub-valvular techniques, reshaping organs, annuloplasty, and the like. Utilization of the disclosed echogenic sutures can result in superior outcomes due at least in part to physicians being able to better visualize the placement and/or tension of the echogenic sutures.

Abstract: A tissue anchor delivery device includes a handle, an elongate shaft projecting from the handle, a carrier configured to linearly translate within the handle, an elongate pusher shaft disposed at least partially within a lumen of the elongate shaft, a pusher hub coupled to the pusher shaft, the pusher hub being movably disposed within the handle and releasably coupled to the carrier, an elongate needle movably disposed at least partially within a lumen of the pusher shaft, a needle hub coupled to the needle, the needle hub being movably disposed within the handle and releasably coupled to the carrier, a suture having one or more strands that pass through at least a portion of lumen of the needle, a tissue anchor associated with a distal portion of the suture, and an actuator configured to cause movement of the carrier.

Abstract: A method of suturing a tissue opening can comprise placing a tissue-facing surface of a first pad, a second pad and a third pad over respective tissue areas adjacent to the tissue opening. The second pad can be positioned on a first side of the first pad and the third pad can be positioned on a second side of the first pad. The first and second pads can be coupled to a suture, the suture forming a stitch over the upper surface of each of the respective pads. The suture can be stitched through an area of tissue between the first pad and the second pad, between the second pad and the third pad, and between the third pad and the first pad. A first distal portion and a second distal portion of the suture can be coupled to the third pad for forming the purse-string suture.

Abstract: A delivery system comprises a first delivery shaft configured to deliver one or more sutures to a leaflet of a heart. The first delivery shaft has an end effector at a distal end of the first delivery shaft and configured to contact the leaflet. The delivery system further comprises a needle configured to extend from the distal end of the first delivery shaft and through the leaflet and a support arm configured to contact and extend at least partially along the leaflet during delivery of the needle through the leaflet.

Abstract: A tissue anchor delivery device includes a handle, an elongate shaft extending from the handle, a pusher tube disposed at least partially within a lumen of the elongate shaft, a pusher hub coupled to the pusher tube, a needle disposed at least partially within a lumen of the pusher tube, a needle hub coupled to the needle, and an actuator configured to be fixed to the pusher hub and the needle hub. The actuator is further configured to advance the needle hub and the pusher hub a first distance, thereby causing a tip of the needle to protrude from a distal end of the elongate shaft, disengage from the needle hub, and advance the pusher hub a second distance relative to the needle hub, thereby causing a distal end of the pusher tube to advance over the needle and push a coiled suture form off of the needle.

Abstract: A method of tethering can comprise providing a tether deployment device. The tether deployment device can comprise an elongate shaft comprising a lumen extending from a proximal end to a side opening, an atraumatic distal effector coupled to a distal end of the elongate shaft, and a tether deployment assembly at least partially received within the lumen. The method can include advancing the distal portion of the elongate shaft into a heart chamber, positioning a distally oriented surface of the atraumatic distal effector against a first tissue area, and advancing a distal portion of the tether deployment assembly through the side opening of the shaft. A portion of at least one tether can be deployed to the target tissue area using the tether deployment assembly while the distally oriented surface of the atraumatic distal effector is against the first tissue area.

Abstract: A device for treating a heart valve comprising a curved frame and a covering at least partially enclosing the curved frame.

Abstract: Septal defect repair involves advancing an elongate shaft into an atrium of a heart of a patient through an outer atrial wall of the heart, contacting an atrial septum of the heart with a distal end of the elongate shaft, deploying a plurality of tissue anchors from the elongate shaft in tissue of the atrial septum, and cinching suture tails associated with the plurality of tissue anchors to at least partially close a defect in the atrial septum.

Abstract: A reinforced surgical pad device can comprise a surgical pad configured to be positioned over an opening in a target tissue, and a reinforcement member configured to be associated with the surgical pad. The reinforcement member can comprise a central portion being configured to be associated with the surgical pad, and a circumferential portion around the central portion, at least a portion of the circumferential portion being configured to extend laterally beyond an outer edge of the surgical pad.

Abstract: Described herein are devices and methods for mitral valve repair. The devices and methods implant a plurality of distal anchors at an annulus of the mitral valve (e.g., the posterior annulus) and tension artificial chordae to pull the portion of the annulus toward an opposite edge and inward into the ventricle. This can effectively reduce the size of the orifice and increase coaptation. The delivery devices can be configured to be actuated to form a distal anchor made of a pre-formed knot. The delivery devices deliver the pre-formed knot in an elongate configuration. Actuation of the delivery device causes the pre-formed knot to transition from the elongate configuration to the deployed configuration by approximating opposite ends of a suture coupled to a coiled configuration to form one or more loops. After formation of the knot, the delivery device can be withdrawn.

Abstract: Systems, apparatuses, and methods disclosed herein may be directed to clips for medical implementation, including clips for a portion of a heart. The clips may be configured to close the portion of the heart, to reduce blood flow therethrough as well as passage of clots or other undesired materials. In examples, the clips may be configured to close the left atrial appendage (LAA). The closure of the LAA may reduce the possibility of stroke or other maladies stemming from fluid flow with the LAA. In examples, the clips may be positioned exterior of the LAA, to extend over an outer surface of the LAA for closure.

Abstract: Described herein are devices and methods for mitral valve repair. The devices and methods implant a plurality of distal anchors at an annulus of the mitral valve (e.g., the posterior annulus) and tension artificial chordae to pull the portion of the annulus toward an opposite edge and inward into the ventricle. This can effectively reduce the size of the orifice and increase coaptation. The delivery devices can be configured to be actuated to form a distal anchor made of a pre-formed knot. The delivery devices deliver the pre-formed knot in an elongate configuration. Actuation of the delivery device causes the pre-formed knot to transition from the elongate configuration to the deployed configuration by approximating opposite ends of a suture coupled to a coiled configuration to form one or more loops. After formation of the knot, the delivery device can be withdrawn.

Abstract: Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post-deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture. A visualization system can be used to provide visual feedback with respect to approximating the targeted tissue and the locking sutures.

Abstract: An introducer device includes a proximal hub including a first port and a second port, first and second fluid valves associated with the first port and the second port, respectively, a first elongate lumen projecting distally from the proximal hub, the first elongate lumen being in fluid communication with the first port, and a second elongate lumen projecting distally from the proximal hub, the second elongate lumen being in fluid communication with the second port and fluidly isolated from the first elongate lumen.

Abstract: Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post-deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture.

Abstract: Described herein are cords (or sutures) and methods for using cords wherein the cords comprise a synthetic aromatic polyamide (or aramid) polymer, wherein the cords comprise a core of a high-strength material such as a polymer (e.g., PET), aramid, ceramic, or metal with a coating of ePTFE encapsulating the core, or wherein the cords comprise braided strands of ePTFE. The disclosed cords have higher strength and durability than typical ePTFE cords or sutures. Furthermore, disclosed herein are methods that utilize the disclosed cords in cardiac repairs, thereby resulting in repairs that are superior to repairs that utilize typical ePTFE cords.

Abstract: A tissue anchor delivery device includes a handle, an elongate shaft extending from the handle, a pusher tube disposed at least partially within a lumen of the elongate shaft, a pusher hub coupled to the pusher tube, a needle disposed at least partially within a lumen of the pusher tube, a needle hub coupled to the needle, and an actuator configured to be fixed to the pusher hub and the needle hub. The actuator is further configured to advance the needle hub and the pusher hub a first distance, thereby causing a tip of the needle to protrude from a distal end of the elongate shaft, disengage from the needle hub, and advance the pusher hub a second distance relative to the needle hub, thereby causing a distal end of the pusher tube to advance over the needle and push a coiled suture form off of the needle.

Abstract: A delivery system comprises two or more needles including at least a first needle comprising a distal tip configured to pierce a valve leaflet of a heart, two or more leaflet anchors, each of the two or more leaflet anchors configured to be delivered via one of the two or more needles, and a shaft comprising a first interior lumen configured to slidably receive the two or more needles, the shaft having a first opening into the first interior lumen at a distal end of the shaft, the first opening configured to allow at least the first needle to exit the shaft.