Suture tension distribution
A tension-distribution device includes a rotationally-symmetric structure and two or more suture-engagement features associated with the rotationally-symmetric structure, the suture-engagement features being configured to receive one or more suture portions therein. The two or more suture-engagement features are evenly spaced rotationally about an axial center of the rotationally-symmetric structure.
1 . A method for tensioning sutures in a patient in need thereof, the method comprising:
providing a rotationally-symmetric tension-distribution device including:
a first plate, and
a dome-shaped fulcrum projecting from the first plate and configured to facilitate tilting of the first plate about a center of the fulcrum, the fulcrum having a lateral extent that is smaller than the first plate such that a rim of the first plate extends radially outward beyond the fulcrum;
engaging one or more first suture portions with a first suture-engagement feature associated with a first circumferential position of the rim of the first plate radially outside of the fulcrum;
engaging one or more second suture portions with a second suture-engagement feature associated with a second circumferential position of the rim of the first plate that is on an opposite side of the first plate from the first circumferential position; and
adjusting tension of the one or more first suture portions and tension of the one or more second suture portions at least in part by permitting the first plate to tilt about the fulcrum of the tension-distribution device in response to greater tension in the one or more first suture portions compared to the one or more second suture portions.
2 . The method of claim 1 , wherein said engaging the one or more first suture portions with the first suture-engagement feature comprises fixing tension of the one or more first suture portions at the first suture-engagement feature.
3 . The method of claim 1 , wherein said engaging the one or more first suture portions with the first suture-engagement feature comprises looping the one or more first suture portions around the first suture-engagement feature, the first suture-engagement feature comprising a peg that projects radially from the rim of the first plate.
4 . The method of claim 1 , further comprising further adjusting the tension of the one or more first suture portions and the tension of the one or more second suture portions manually to tilt the first plate of the tension-distribution device to a balanced orientation.
5 . The method of claim 4 , further comprising clamping the tension of the one or more first suture portions and the tension of the one or more second suture portions after tilting the first plate of the tension-distribution device to the balanced orientation.
6 . The method of claim 1 , wherein said adjusting is performed postoperatively within a closed chest cavity of the patient.
7 . The method of claim 1 , further comprising pulling slack out of at least one of the one or more first suture portions or the one or more second suture portions prior to said engaging the one or more first suture portions.
8 . The method of claim 1 , wherein the first suture-engagement feature and the second suture-engagement feature are positioned:
on a common radial axis of the tension-distribution device; and
on opposite sides of the tension-distribution device.
9 . The method of claim 1 , wherein:
the one or more first suture portions are associated with a first implanted tissue anchor; and
the one or more second suture portions are associated with a second implanted tissue anchor.