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 annuloplasty implant is provided for treating a native atrioventricular valve of a patient, the annuloplasty implant including a plurality of tissue anchors, which are configured to anchor the annuloplasty implant around at least a portion of a valve annulus of the native atrioventricular valve. The annuloplasty further includes a contracting assembly, which includes an elongate contracting member; and a contracting mechanism, which is coupled to the elongate contracting member, and which is configured, upon actuation thereof, to apply a longitudinal contracting force to the elongate contracting member that longitudinally contracts at least a portion of the annuloplasty implant, thereby circumferentially tightening the valve annulus. The annuloplasty further includes a force-distributing element, which includes a longitudinally-non-compressible tightly-coiled element, and which is configured to distribute the longitudinal contracting force over at least two of the tissue anchors.

Abstract: An implant structure includes a contracting mechanism, including a rotatable structure for contracting the implant structure, and a locking mechanism. A rotation tool is configured to engage and rotate the rotatable structure. A longitudinal guide member is removably coupled to the contracting mechanism, configured to guide the rotation tool to the rotatable structure, and includes a distal force applicator. The rotation tool is axially moveable with respect to the guide member. The contracting mechanism is arranged such that the locking mechanism is (a) unlocked when the guide member is coupled to the contracting mechanism in a first state, thereby allowing the rotatable structure to rotate, and (b) locked when (i) the guide member is coupled to the contracting mechanism in a second state, thereby restricting the rotation of the rotatable structure, and (ii) the guide member is not coupled to the contracting mechanism, thereby restricting the rotation of the rotatable structure.

Abstract: An automatic injector for delivering a pharmaceutical substance from a reservoir of a cartridge, the cartridge interconnected to a needle at its distal end and mechanically coupled to a plunger driver at its proximal end, the injector comprising a connecting feature on the cartridge a contact surface for contacting an injection site a frame connected to the contact surface, the frame having an interference element with a distal stop, the interference element sized to slidably link to the connecting feature and allow the cartridge to slide up to the distal stop, a snap element allowing the interference element to receive the connection feature, but inhibiting disconnection of the cartridge; the frame further comprising a driver mount, for fixedly containing a plunger driver, the driver for driving a plunger to empty the reservoir of the cartridge through the needle to inject fluid from the reservoir into the injection subject.

Abstract: Apparatus includes a tube and an implant moveable at least in part through a lumen of the tube. The implant includes a longitudinal member and a locking mechanism coupled to the longitudinal member. The locking mechanism has (i) an unlocked state in which the locking mechanism is configured to facilitate adjustment of tension of the longitudinal member, and (ii) a locked state in which the locking mechanism is configured to restrict adjustment of the tension of the longitudinal member. A tool maintains the locking mechanism in the unlocked state via contact of the tool with the locking mechanism in the heart, and moves the locking mechanism into the locked state. The locking mechanism is disposed distally to the distal end of the tube while the longitudinal member is disposed entirely within the tube. Other applications are also described.

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: A wearable pharmaceutical delivery device is disclosed including a compressed elastic power source and a cylindrical pharmaceutical reservoir. Optionally, the compressed power source is positioned along a bent path. Alternatively or additionally, the compressed power source may power discharge of the pharmaceutical. Alternatively or additionally, the compressed power source may power extension of an injection needle. In some embodiments, a tensile element may activate an indicator when delivery of the pharmaceutical is complete.

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: An apparatus is provided for connecting a portable medical device, such as an automatic injector, and a server. The apparatus includes a communication unit, a recognition unit for recognizing identification information on the portable medical device, and a pairing unit connected to the recognition unit to pair the apparatus with the portable medical device when recognized, thereby opening a first channel of communication with the medical device. The communication unit is configured to open up a second channel of communication with a server remotely over a network, and form a communication route between the portable medical device and the server.

Abstract: Apparatus is described for administering a substance to a subject. A vial contains the substance and a stopper is disposed within the vial and is slidably coupled to the vial. A first threaded element is (a) rotatable with respect to the vial and (b) substantially immobile proximally with respect to the vial during rotation of the first threaded element. A second threaded element is threadedly coupled to the first threaded element. At least a distal end of the second threaded element is substantially non-rotatable with respect to the vial, and the distal end of the second threaded element defines a coupling portion that couples the second threaded element to the stopper. The first threaded element, by rotating, linearly advances the stopper and at least the distal end of the second threaded element toward a distal end of the vial. Other embodiments are also described.

Abstract: A method is provided including inserting into a heart a tissue-adjusting member selected from the group consisting of: one or more artificial chordae tendineae and an annuloplasty ring structure. An adjusting mechanism of the tissue-adjusting member adjusts tension of the tissue-adjusting member. The adjusting mechanism: (a) includes a locking mechanism configured to restrict adjusting of the tissue-adjusting member by the adjusting mechanism, and (b) is shaped to define a first coupling. The method further includes, using a tool reversibly coupled to the adjusting mechanism, restricting the adjusting of the tissue-adjusting member by the adjusting mechanism, by facilitating movement of the locking mechanism into a locked state. The tool is shaped to define a second coupling that mates with the first coupling of the adjusting mechanism. The first and second couplings are coupled together and remain mated during the restricting of the adjusting of the tissue-adjusting member.

Abstract: Apparatus is described for administering a substance to a subject. A vial contains the substance and a stopper is disposed within the vial and is slidably coupled to the vial. A first threaded element is (a) rotatable with respect to the vial and (b) substantially immobile proximally with respect to the vial during rotation of the first threaded element. A second threaded element is threadedly coupled to the first threaded element. At least a distal end of the second threaded element is substantially non-rotatable with respect to the vial, and the distal end of the second threaded element defines a coupling portion that couples the second threaded element to the stopper. The first threaded element, by rotating, linearly advances the stopper and at least the distal end of the second threaded element toward a distal end of the vial. Other embodiments are also described.

Abstract: During a percutaneous procedure, a flexible sleeve of an annuloplasty structure is introduced into an atrium and arranged completely around an annulus as a closed loop, such that none of one or more longitudinal contracting members thereof is positioned along an anterior portion of the annulus between fibrous trigones of the valve. The annuloplasty structure is fastened to the annulus. At least a portion of a posterior portion of the annulus is tightened, while preserving a length of an anterior portion of the annulus between fibrous trigones of the valve, by contracting, using the one or more longitudinal contracting members, a longitudinal portion of the sleeve not positioned along the anterior portion of the annulus between the fibrous trigones of the valve. Thereafter, the one or more longitudinal contracting members are locked.

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: An implant structure, comprises a body portion, a first adjusting mechanism, and a second adjusting mechanism. The body portion is configured to be secured around an annulus of a native valve of a heart of a patient. The first adjusting mechanism is coupled to a first portion of the body portion, and comprises a first ring that surrounds the first portion and is moveable with respect to the body portion. The second adjusting mechanism is coupled to a second portion of the body portion, and comprises a second ring that surrounds the second portion and is moveable with respect to the body portion. A first elongate tool is configured to remodel tissue of the heart by actuating the first adjusting mechanism. A second elongate tool is configured to remodel tissue of the heart by actuating the second adjusting mechanism.

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. Either or both of the tubes are formed with patterns of cuts made along adjacent longitudinal stations along a length of the cut tube. The cutting pattern at a first longitudinal station is shifted with respect to a cutting pattern at a second longitudinal station and a cutting pattern at the second longitudinal station is shifted with respect to a cutting pattern at a third longitudinal station but at a different shift defined between the first and second longitudinal stations, so that a shift from one longitudinal station of cuts to the next adjacent longitudinal station of cuts is not repeated.

Abstract: Apparatus is described for administering a substance to a subject. A vial contains the substance and a stopper is disposed within the vial and is slidably coupled to the vial. A first threaded element is (a) rotatable with respect to the vial and (b) substantially immobile proximally with respect to the vial during rotation of the first threaded element. A second threaded element is threadedly coupled to the first threaded element. At least a distal end of the second threaded element is substantially non-rotatable with respect to the vial, and the distal end of the second threaded element defines a coupling portion that couples the second threaded element to the stopper. The first threaded element, by rotating, linearly advances the stopper and at least the distal end of the second threaded element toward a distal end of the vial. 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: 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.

Abstract: A status of a battery operated infuser may be detected by measuring a controlled input parameter. The measurement may be used to determine a magnitude of the input parameter and a parameter of the control. For example, control of power input to a motor may be by pulse density modulation. An integral of current over time may serve as a measure of current magnitude and pulse density. The result of the integral may be used to determine the status of the injector. The status may include normal functions for example start of pumping and/or malfunctions such as occlusion or drive disengagement.