Abstract: Within a delivery passage of a catheter, an elongated and flexible annuloplasty structure is transluminally advanced toward a heart of a subject while the annuloplasty structure is in a substantially linear configuration in which a distal end of the annuloplasty structure is closer than a proximal end of the annuloplasty structure to a distal opening of the catheter. Subsequently, the distal end of the annuloplasty structure is advanced, followed by the proximal end of the annuloplasty structure, out of the catheter and into an atrium of the heart. Within the atrium, the annuloplasty structure is transitioned toward a ring form by the distal end of the annuloplasty structure being brought towards the proximal end of the annuloplasty structure. While the annuloplasty structure remains in the ring form, the annuloplasty structure is placed against tissue of the annulus and is anchored to the tissue.

Abstract: Apparatuses, systems, and devices usable for annuloplasty are provided. These can include an annuloplasty system comprising a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube having a distal portion that is movable through the lumen of the segment and a distal end passable through an opening in the segment that is in fluid communication with the lumen. One or more tissue anchors are deliverable through the tube, the tissue anchor(s) being shaped so as to define a tissue coupling element. The distal portion of the tube can be removably positioned within the lumen of the segment, and, while so positioned, to deploy the tissue coupling element from the distal end of the tube in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.

Abstract: Apparatus includes an implant including a flexible longitudinal member extending along a longitudinal length of the implant and a flexible contracting member extending alongside the longitudinal member and along the longitudinal length of the implant. The contracting member is configured to facilitate reduction of a perimeter of the implant by applying a contracting force to the longitudinal member in response to an application of force to the contracting member. The contracting member is disposed at a radially outer perimeter of the longitudinal member and configured to apply a pushing force to the longitudinal member responsively to the application of the force to the contracting member.

Abstract: Within a delivery passage of a catheter, an elongated and flexible annuloplasty structure is transluminally advanced toward a heart of a subject while the annuloplasty structure is in a substantially linear configuration in which a distal end of the annuloplasty structure is closer than a proximal end of the annuloplasty structure to a distal opening of the catheter. Subsequently, the distal end of the annuloplasty structure is advanced, followed by the proximal end of the annuloplasty structure, out of the catheter and into an atrium of the heart. Within the atrium, the annuloplasty structure is transitioned toward a ring form by the distal end of the annuloplasty structure being brought towards the proximal end of the annuloplasty structure. While the annuloplasty structure remains in the ring form, the annuloplasty structure is placed against tissue of the annulus and is anchored to the tissue.

Abstract: Apparatuses, systems, and devices usable for valve repair are provided. These can include a valve repair system comprising an annuloplasty structure positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube or plurality of tubes. One or more tissue anchors are deliverable through the tube or plurality of tubes, the tissue anchor(s) being shaped so as to each define a tissue coupling element. The tissue coupling element(s) can be deployed from the distal end of the tube or plurality of tubes in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.

Abstract: Apparatuses, systems, and devices usable for annuloplasty are provided. These can include an annuloplasty system comprising a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube having a distal portion that is movable through the lumen of the segment and a distal end passable through an opening in the segment that is in fluid communication with the lumen. One or more tissue anchors are deliverable through the tube, the tissue anchor(s) being shaped so as to define a tissue coupling element. The distal portion of the tube can be removably positioned within the lumen of the segment, and, while so positioned, to deploy the tissue coupling element from the distal end of the tube in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.

Abstract: Apparatus includes an implant including a flexible longitudinal member extending along a longitudinal length of the implant and a flexible contracting member extending alongside the longitudinal member and along the longitudinal length of the implant. The contracting member is configured to facilitate reduction of a perimeter of the implant by applying a contracting force to the longitudinal member in response to an application of force to the contracting member. The contracting member is disposed at a radially outer perimeter of the longitudinal member and configured to apply a pushing force to the longitudinal member responsively to the application of the force to the contracting member.

Abstract: Apparatuses and devices usable for annuloplasty are provided. These can include a plurality of tissue anchors and an annuloplasty structure for placement on a heart valve annulus. The annuloplasty structure can include a plurality of compressible or adjustable subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible/adjustable subunits. The anchor mounts are coupleable to the tissue anchors and can define a path for passage therethrough of a respective tissue anchor. The apparatuses and devices can be independently adjustable and can be adjustable for treating various sizes of patient annuli. Other embodiments are also described.

Abstract: Apparatuses and devices usable for annuloplasty are provided. These can include a plurality of helical tissue anchors and an annuloplasty structure for placement on a heart valve annulus. The annuloplasty structure can include a plurality of compressible or adjustable subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible/adjustable subunits. The anchor mounts are coupleable to the helical anchors and can define a path for passage therethrough of a respective helical tissue anchor. The apparatuses and devices can be independently adjustable and can be adjustable for treating various sizes of patient annuli. Other embodiments are also described.

Abstract: Apparatus is provided, including an implant including a flexible longitudinal member extending along a longitudinal length of the implant, and a flexible contracting member extending alongside the longitudinal member and along the longitudinal length of the implant. The contracting member is configured to facilitate reduction of a perimeter of the implant by applying a contracting force to the longitudinal member in response to an application of force to the contracting member. The longitudinal member has first and second ends, and the first end is movable with respect to the second end responsively to the applying of the contracting force to the longitudinal member by the contracting member. The apparatus includes a lock coupled to the longitudinal member. The lock is engageable with the longitudinal member to restrict movement of the longitudinal member.

Abstract: Apparatuses and devices usable for annuloplasty are provided. These can include a plurality of helical tissue anchors and an annuloplasty structure for placement on a heart valve annulus. The annuloplasty structure can include a plurality of compressible or adjustable subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible/adjustable subunits. The anchor mounts are coupleable to the helical anchors and can define a path for passage therethrough of a respective helical tissue anchor. The apparatuses and devices can be independently adjustable and can be adjustable for treating various sizes of patient annuli. Other embodiments are also described.

Abstract: Apparatuses and devices usable for annuloplasty are provided. These can include a plurality of tissue anchors and an annuloplasty structure for placement on a heart valve annulus. The annuloplasty structure can include a plurality of compressible or adjustable subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible/adjustable subunits. The anchor mounts are coupleable to the tissue anchors and can define a path for passage therethrough of a respective tissue anchor. The apparatuses and devices can be independently adjustable and can be adjustable for treating various sizes of patient annuli. Other embodiments are also described.

Abstract: Apparatus is provided, including an intracardiac annuloplasty structure configured for placement on an annulus of a heart valve, a first rotatable ring coupled to the annuloplasty structure and a second rotatable ring coupled to the annuloplasty structure. The first and second rotatable rings are arranged such that the first rotatable ring is rotatable to contract the annuloplasty structure while the second rotatable ring remains stationary, and the second rotatable ring is rotatable to contract the annuloplasty structure while the first rotatable ring remains stationary. Other embodiments are also described.

Abstract: Apparatus is provided, including a plurality of helical tissue anchors and an intracardiac annuloplasty structure defining a plane for placement on a heart valve annulus. The annuloplasty structure includes a plurality of compressible subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible subunits. Each anchor mount (a) defines at least one opening for passage therethrough of a respective helical tissue anchor, (b) defines a path for passage therethrough of the helical tissue anchor, the path being aligned along an axis that is at a non-zero angle with respect to the plane of the annuloplasty structure, and (c) provides a structural element in the path for corkscrewing a distal portion of the helical tissue anchor therearound. Other embodiments are also described.

Abstract: Apparatus is provided, including an intracardiac annuloplasty structure. A first adjustment member has an end at a first location at first portions of the annuloplasty structure that are opposite each other. A second adjustment member has an end at a second location at the second portions of the annuloplasty structure that are opposite each other. The annuloplasty structure, the first-adjustment-member end, and the second-adjustment-member end are disposed within a catheter during delivery. After delivery, the first-adjustment-member end is moveable with respect to the annuloplasty structure toward and away from a plane of the annuloplasty structure to adjust a relative disposition of the first portions, and the second-adjustment-member end is moveable independently of the first-adjustment-member end and with respect to the annuloplasty structure toward and away from the plane to adjust a relative disposition of the second portions. Other embodiments are also described.

Abstract: Apparatus is provided, including a locking mechanism, an implant, and a flexible strip within the implant having a plurality of recesses. A perimeter of the strip shortens and expands when the first end of the strip is advanced bidirectionally with respect to a second end of the strip. The locking mechanism includes a moveable recess-engaging portion, a mechanical support removably coupled to the recess-engaging portion, and a force applicator which maintains the recess-engaging portion in a position in which the recess-engaging portion is not disposed in any of the recesses. Upon decoupling of the mechanical support from the recess-engaging portion, the force applicator restricts motion of the plurality of recesses of the strip with respect to the second end of the strip, by facilitating positioning of the recess-engaging portion in one of the plurality of recesses. Other embodiments are also described.

Abstract: A method is provided, including providing an implant shaped to define a lumen and a flexible strip disposed at least in part within the lumen, and a plurality of recesses, the implant including a locking mechanism to which first and second ends of the strip are coupled such that the strip defines a closed loop which shortens when the first end is advanced through the locking mechanism in a first direction, and expands when the first end is advanced in a second opposite direction; advancing the first end in first and second opposing directions with respect to the second end; maintaining a recess-engaging portion in a position in which the recess-engaging portion is not disposed in any of the recesses during the advancing; and restricting the advancing by facilitating active positioning of the recess-engaging portion in one of the recesses. Other embodiments are also described.

Abstract: Apparatus is provided, including an intracardiac annuloplasty structure. A first adjustment member has an end at a first location at first portions of the annuloplasty structure that are opposite each other. A second adjustment member has an end at a second location at the second portions of the annuloplasty structure that are opposite each other. The annuloplasty structure, the first-adjustment-member end, and the second-adjustment-member end are disposed within a catheter during delivery. After delivery, the first-adjustment-member end is moveable with respect to the annuloplasty structure toward and away from a plane of the annuloplasty structure to adjust a relative disposition of the first portions, and the second-adjustment-member end is moveable independently of the first-adjustment-member end and with respect to the annuloplasty structure toward and away from the plane to adjust a relative disposition of the second portions. Other embodiments are also described.

Abstract: Apparatus is provided, including a plurality of helical tissue anchors and an intracardiac annuloplasty structure defining a plane for placement on a heart valve annulus. The annuloplasty structure includes a plurality of compressible subunits, and a plurality of anchor mounts alternately disposed with respect to the plurality of compressible subunits. Each anchor mount (a) defines at least one opening for passage therethrough of a respective helical tissue anchor, (b) defines a path for passage therethrough of the helical tissue anchor, the path being aligned along an axis that is at a non-zero angle with respect to the plane of the annuloplasty structure, and (c) provides a structural element in the path for corkscrewing a distal portion of the helical tissue anchor therearound. Other embodiments are also described.

Abstract: Apparatus is provided, including an intracardiac annuloplasty structure configured for placement on an annulus of a heart valve, a first rotatable ring coupled to the annuloplasty structure and a second rotatable ring coupled to the annuloplasty structure. The first and second rotatable rings are arranged such that the first rotatable ring is rotatable to contract the annuloplasty structure while the second rotatable ring remains stationary, and the second rotatable ring is rotatable to contract the annuloplasty structure while the first rotatable ring remains stationary. Other embodiments are also described.