Abstract: A steering tool includes an internal tube disposed inside an external tube. The internal and external tubes are arranged for longitudinal axial movement relative to one another. A distal portion of the internal tube is fixedly joined to a distal portion of the external tube. At least one of the tubes may include, over at least some of its length, two continuous, longitudinal zones of solid material separated from each other by a longitudinal gap. At least one of the tubes may include a flexible distal portion distal to the joining zone, the flexible distal portion being more flexible than other portions of that tube.

Abstract: A tissue anchor is provided for use with a valve-repair implant configured to be coupled to cardiac tissue of a patient. The tissue anchor includes a distal tissue coupling element configured to couple the tissue anchor to the cardiac tissue of the patient. It further comprises a proximal implant-penetrating element configured to penetrate at least a portion of the valve-repair implant and facilitate coupling of the valve-repair implant to the tissue anchor. The proximal implant-penetrating element includes an implant-restraining element coupled to a portion of the implant-penetrating element. The implant-restraining element is configured to restrain the valve-repair implant from separating from the implant-penetrating element. Other applications of the present invention are also described.

Abstract: An add-on for a self-injector including an adaptor and a bent fluid path is provided. The adaptor includes at least one coupling sized and shaped to couple the adaptor to a fluid reservoir. The bent fluid path is configured at a first end to penetrate tissue and coupled at a second end to the adaptor. The add-on coupled to the fluid reservoir forms an integral self-injector cartridge unit configured to be sterilized and filled with an injectable. The adaptor is configured to couple to a self-injector at least one of a plurality of reservoirs having different sizes and tip types.

Abstract: A wearable medical device may be unpacked, prepared, and/or used while being grasped with a single hand position. For example, the device may be removed from a package, primed, and/or adhered to the skin of a user while being grasped with the single hand position. Optionally, the device may be used with a single hand. Optionally, the device includes a delivery interface (for example, including a needle tip and/or a skin contact surface). Optionally, the device includes a protector that preserves sterility of the delivery interface. Optionally, the cover can be removed with a single hand. Optionally, removal of the cover is performed with the same hand position as placement of the device on a delivery site.

Abstract: An injector including at least one fluid reservoir having a needle, a surface attached to skin and coupled to the fluid reservoir by at least a first joint and a second joint at least a portion of one of the joints being slidable or having interlocking arms. At least a portion of a path of translation of a slidable portion of the first joint and a portion of a path of translation of the second joint are angled in respect to each another.

Abstract: A method is described for use at a valve of a heart of a subject, the valve having an annulus, and the heart having an atrium upstream of the valve. A distal end of a manipulator is transluminally advanced into the atrium. A first part of an implant that includes an elongated contracting member is anchored to a first site on the annulus using the manipulator. The distal end of the manipulator is then pointed at a second site on the annulus such that a central longitudinal axis of the manipulator is disposed at an angle of 45-90 degrees with respect to a surface of the annulus. A second part of the implant is then anchored to the second site using the manipulator. Subsequently, the first site and the second site are drawn together by applying tension to the contracting member. Other embodiments are also described.

Abstract: An extender for filling a syringe cartridge at a filling station having an elevating bar has a connector portion connecting a proximal portion of the extender to a distal portion of the syringe cartridge. A head on a distal portion of the extender is sized and shaped to engage the elevating bar of the filling station. The syringe cartridge having the extender may be provided to a filling station that is configured for filling a long syringe cartridge having a long syringe-cartridge length greater than a length of the syringe cartridge. The syringe cartridge and extender may be supported on a syringe support of the filling station and passed through the filling station to fill the syringe cartridge.

Abstract: Apparatus is provided for repairing a cardiac valve, the apparatus including a catheter sized for delivery through vasculature of a subject and an elongated and flexible annuloplasty structure having an elongated lumen and an annuloplasty structure axis extending along the lumen. The annuloplasty structure is sized and configured for delivery to a heart of the subject through the catheter substantially along a catheter axis of the catheter while the annuloplasty structure axis is substantially parallel to the catheter axis. The apparatus also includes a plurality of anchors configured for delivery to a region of cardiac tissue from a proximal end of the catheter toward a distal end of the catheter and substantially along the annuloplasty structure axis and the catheter axis while at least a portion of the annuloplasty structure is within a delivery passage of the catheter. Other embodiments are also described.

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: Disclosed herein is a pharmaceutical syringe having a cylindrical bore with a proximal opening, the syringe comprising a distal wall of the bore defining an outlet biased from the central axis of the syringe, and toward a first area of the distal wall and biased from the central axis away from a second area distinct from the first area; the syringe comprising a plunger seal having a distal surface; wherein when the plunger seal is fitted into the bore with the distal surface facing an inner surface of the distal wall of the bore, the second area of the inner surface is axially closer to the distal surface of the plunger seal than the first area, in a direction parallel to the central axis of the cylindrical bore, such that fluid is expelled from the second area and towards the outlet.

Abstract: A tube and a set of anchors, are transluminally advanced toward a heart of a subject. Tabs are distributed axially along an anchor storage area of the tube, each of the tabs protruding medially from a circumferential wall of the tube. The anchors are disposed in the anchor storage area, a first anchor engaged and restrained by a first tab at a first axial location of the tube, and a second anchor engaged and restrained by a second tab at a second axial location of the tube proximal from the first axial location. The first anchor is engaged by the driver at the first axial location, advanced to a distal end of the tube, and anchored to tissue of the heart. Subsequently, the second anchor is engaged by the driver at the second axial location, advanced to the distal end of the tube, and anchored to the tissue.

Abstract: An ingestible pill is provided that includes an enteric coating and a medication-delivery device, which includes (a) a patch having upper and lower surfaces that face in generally opposite directions, and (b) needles. The patch is disposed within the enteric coating, folded so as to define one or more creases, which define respective inner and outer crease sides, wherein at least 50% of the needles are coupled to the patch along the inner crease sides. The patch is configured to assume, after the enteric coating dissolves, an expanded shape, in which the patch has an outer perimeter. Other embodiments are also described.

Abstract: An assembly of a drug delivery system, comprising: a first component; a second component which is configured to move linearly with respect to the first component; and, a resistance element configured to resist linear movement during transport of the first component with respect to the second component in a closed transport configuration but which is adapted to be overcome during nominal operation of the drug delivery system.

Abstract: An annuloplasty implant comprises a flexible member, helical anchors, and non-compressible portions. The helical anchors are configured to anchor the flexible member at least partway around the valve by being screwed into tissue of the heart of a subject. Each of the non-compressible portions comprises a helical coil having a plurality of turns, and at rest has a helix pitch that contacts each turn of the coil with an adjacent turn of the coil. The flexible member extends through the non-compressible portions. The implant is configured such that applying tension to the flexible member from one end thereof contracts the implant, thereby drawing the anchors closer to each other, the helical coil of each of the non-compressible portions inhibiting contraction of the implant at the non-compressible portion.

Abstract: A drug delivery device is disclosed that includes a housing including a channel, a drug reservoir fitting into the channel, and a friction element extending from a housing to the channel to contact an exterior side wall of the reservoir when the reservoir is inserted into the channel. The friction element is configured and oriented to wedge between the exterior wall and the reservoir when the reservoir is rotated in a first rotational direction.

Abstract: An implantable prosthetic device for repairing a native valve includes a first clip, a second clip, a first cord, and a second cord. The first clip has a first arm and a second arm and is moveable between an open position and a closed position. The second clip has a third arm and a fourth arm and is moveable between an open position and a closed position. The first cord is operatively coupled to the first clip for moving the first clip between the open and closed position. The second cord is operatively coupled to the second clip for moving the second clip between the open and closed position. The device is configured to clamp a first leaflet of the native mitral valve between the first arm and the second arm and to clamp a second leaflet of the native mitral valve between the third arm and the fourth arm.

Abstract: A patch injector (10) for parenteral administration of a drug to a drug recipient has a drug-cartridge module (14) attached to a power-pack module (12) and to a drug-recipient interface module (16). A compressed, elastic power element (18) disposed in the power-pack module (12) is coupled to a plunger (30) movably disposed in a drug reservoir (22) in the drug-cartridge module (14). An injection needle (24) at the distal end of the drug reservoir (22) is oriented orthogonal to the drug reservoir (22) and generally toward a skin-contact surface (28) extending parallel to the longitudinal drug-reservoir axis (22A). The power element (18) is configured to displace the plunger (20) distally into the drug reservoir (22) and to move the injection needle (24) toward the skin-contact surface (28) when the power element (18) expands distally along the drug-reservoir axis (22A).

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: Apparatus is provided for adjusting at least one dimension of an implant. The apparatus includes a rotatable structure having a channel extending between first and second openings of the rotatable structure. The channel is configured for passage therethrough of an elongate tool. The rotatable structure has a lower surface that is shaped to define a first coupling. The apparatus includes a mechanical element having a surface coupled to the lower surface of the rotatable structure. The mechanical element is shaped to provide a second coupling configured to engage the first coupling during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure. The mechanical element has a depressible portion that is disposed in communication with the second opening, and is configured to disengage the first and second couplings in response to a force applied thereto by the elongate tool.

Abstract: Anchor deployment systems and tools are provided. An anchor deployment tool can include a flexible tube including a distal anchor manipulation portion. The tool can also include a deployment element, which is positionable within the flexible tube, and is configured to, while the distal anchor manipulation portion is proximate an implantable device, (i) engage the anchors in the flexible tube, (ii) advance each of the anchors in a distal direction to the distal anchor manipulation portion, and (iii) anchor the implantable device to tissue of a subject by deploying each of the tissue anchors through the implantable device and into the tissue.