Biological Chord Repair System and Methods

1 . A chordal replacement method comprising:

passing a first needle, which is coupled to a first suture length, through papillary muscle;

securing a pledget, which is coupled to the first suture length, to the papillary muscle in response to passing the first needle through the papillary muscle;

passing a second needle, which is coupled to a second suture length, through valve tissue;

securing the second suture length, which is coupled to the pledget, to the valve tissue in response to passing the second needle through the valve tissue;

passing a third needle, which is coupled to a third suture length, through the valve tissue;

securing the third suture length, which is coupled to the pledget, to the valve tissue in response to passing the third needle through the valve tissue;

wherein the second and third suture lengths are not monolithic with each other and do not constitute a single suture.

2 . The method of claim 1 , wherein the second suture length couples to a fourth needle and the third suture length couples to a fifth needle, the method further comprising:

passing the fourth needle through the valve tissue;

further securing the second suture length to the valve tissue in response to passing the fourth needle through the valve tissue;

passing the fifth needle through the valve tissue;

further securing the third suture length to the valve tissue in response to passing the fifth needle through the valve tissue.

3 . The method of claim 2 , wherein the first suture length couples to a sixth needle, the method further comprising passing the sixth needle through the papillary muscle.

4 . The method of claim 3 comprising forming a first suture loop with the first suture length, the first suture loop traversing the pledget.

5 . The method of claim 4 , wherein the first suture loop traverses the papillary muscle.

6 . The method of claim 4 , wherein:

the first and sixth needles are on opposing ends of the first suture length;

the second and fourth needles are on opposing ends of the second suture length;

the third and fifth needles are on opposing ends of the third suture length.

7 . The method of claim 6 , wherein:

the second suture length is knotted and includes a second suture loop that directly connects to the pledget and the first suture length;

the third suture length is knotted and includes a third suture loop that directly connects to the pledget and the first suture length.

8 . The method of claim 7 , wherein neither of the second or third suture loops passes through the pledget.

9 . The method of claim 8 , wherein:

the second suture loop and a knot of the second suture length are monolithic with one another and constitute a single suture; and

the knot of the second suture length couples the second suture loop to the second and fourth needles.

10 . The method of claim 9 comprising:

passing the first needle through an additional pledget; and

securing the additional pledget to the papillary muscle via the first suture loop.

11 . The method of claim 10 comprising passing the sixth needle through the additional pledget.

12 . The method of claim 7 , wherein:

the second suture loop is located entirely between the papillary muscle and the valve tissue;

the third suture loop is located entirely between the papillary muscle and the valve tissue.

13 . The method of claim 12 , wherein the first suture length passes through the second suture loop.

14 . The method of claim 13 , wherein the first suture length passes through the third suture loop.

15 . The method of claim 7 , wherein:

a knot of the second suture length and a knot of the third suture length are both adjustable; and

the second suture loop has an adjustable length based on the knot of the second suture length being adjustable;

the third suture loop has an adjustable length based on the knot of the third suture length being adjustable.

16 . The method of claim 1 wherein the second suture length couples to a fourth needle at one end of the second suture length and couples to the second needle at another end of the second suture length, the method further comprising:

securing the second suture length to the valve tissue by passing the fourth needle through the valve tissue and then coupling the one end of the second suture length to the another end of the second suture length via at least one of a knot, a coupling member, or combinations thereof.

17 . The method of claim 16 comprising forming a second suture loop with the second suture length, the second suture loop traversing the valve tissue.

18 . The method of claim 17 wherein the third suture length couples to a fifth needle at one end of the third suture length and couples to the third needle at another end of the third suture length, the method further comprising:

securing the third suture length to the valve tissue by passing the fifth needle through the valve tissue and then coupling the one end of the third suture length to the another end of the third suture length via at least one of a knot, a coupling member, or combinations thereof.

19 . The method of claim 18 comprising forming a third suture loop with the third suture length, the third suture loop traversing the valve tissue.