Abstract: A two-step delivery method, system and device is disclosed comprising, in various embodiments, a self-expanding frame. A self-expanding frame is delivered and expanded within a heart chamber followed by delivery of a prosthetic valve comprising prosthetic valves thereon into the expanded self-expanding frame, which is in turn connected to a valve connection region defined on and by the delivered and expanded frame.

Abstract: A prosthetic aortic valve is provided including a frame including interconnected stent struts arranged so as to define interconnected stent cells. Upstream ones of the stent cells are located in an upstream half of the frame and define respective upstream peaks. An electrode is disposed at or near an upstream peak of one of the upstream stent cells. First and Second upstream stent struts of the one of the upstream stent cells are joined at the upstream peak. Coupling material is shaped so as to define a first strip that is mechanically coupled to the first upstream stent strut, a second strip that is mechanically coupled to the second upstream stent strut, and a junction, which couples together the first and the second strips, such that the first and the second strips together couple the electrode to the frame at or near the upstream peak. Other embodiments are also described.

Abstract: A sheath facilitating retraction of prosthetic implant is provided. The sheath includes a tubular body, and the distal end of the body is connected with an expandable section. The expandable section has relative converged configuration and flared configuration and includes a primary expandable area and a secondary expandable area. The primary expandable area includes a plurality of first expandable pieces arranged at intervals in a circumferential direction of the body. The secondary expandable area includes a plurality of second expandable pieces arranged at intervals in the circumferential direction of the body, and all the second expandable pieces include two alternating groups consisting of a first group formed by further extending the first expandable pieces to the distal end and a second group formed by connecting strips wound between two adjacent first expandable pieces.

Abstract: An implantable prosthetic valve that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration includes an annular frame including a plurality of angled strut members, a plurality of leaflets disposed within the frame and secured to the frame, and a skirt member secured to the frame. The skirt member is disposed about an edge portion of a leaflet of the plurality of leaflets, and the skirt member includes a plurality of extension portions wrapped around at least one strut member. A cord member is threaded through at least a portion of the plurality of extension portions in a direction along an axis of the at least one strut member to secure the skirt member to the at least one strut member.

Abstract: Features for a heart valve device are described. The device may include a frame with anchors configured to secure the device to tissue. The frame may include a flared end or skirt for additional securement of the implanted device. The device may include a seal such as a barrier and/or cuff for preventing leakage. The device may contract for endovascular delivery of the device to the heart and expand for securement within the heart, such as the within the native mitral valve annulus. The device may include a replacement valve. The valve may have leaflets configured to re-direct blood flow along a primary flow axis.

Abstract: An implantable medical device is disclosed, in which the implantable medical device includes a fluid shunt extending through a wall separating a first cavity and a second cavity within the heart. The fluid shunt includes a first portion adapted to extend into the first cavity within the heart, a second portion adapted to extend into the second cavity within the heart, and an intermediate portion interconnecting the first and second portions. The fluid shunt having a lumen extending between the first and second portions that is adapted to fluidly couple the first and second cavities within the heart.

Abstract: A two-step delivery method, system and device is disclosed comprising, in various embodiments, a self-expanding frame. A self-expanding frame is delivered and expanded within a heart chamber followed by delivery of a prosthetic valve comprising prosthetic valves thereon into the expanded self-expanding frame, which is in turn connected to a valve connection region defined on and by the delivered and expanded frame.

Abstract: The present invention discloses a core assembly, a sheath assembly, a sheath, a sheath processing method and an interventional instrument delivery system and method. A core assembly for delivering an interventional instrument according to the present invention comprises a core tube, a locking member fixed at a distal end of the core tube for connecting the interventional instrument, and a bendable adjustable tube mounted around an outer periphery of the core tube, wherein the distal ends of the bendable adjustable tube and the core tube are fixedly connected to each other, and the proximal ends can slide relative to each other.

Abstract: A valve repair devices and systems for repairing a native valve of a patient include a spacer, a pair of paddles, and a pair of moveable clasp arms. The pair of moveable clasp arms are disposed between the pair of paddles and the spacer. The moveable clasp arms are configured to attach to leaflets of a heart valve. The spacer, the pair of paddles, and the moveable clasp arms are configured such that, when attached to the leaflets, the moveable clasp arms are located between the spacer and first portions of the leaflet, while second portions of the leaflet engage the spacer.

Abstract: A valve repair device for repairing a native valve of a patient includes a spacer element, a pair of paddles, and a pair of gripping members. The pair of paddles is coupled to the spacer element. The pair of gripping members is disposed between the pair of paddles. The paddles and the gripping members are configured to attach to leaflets of a heart valve. The spacer element extends past side edges of the gripping members, extends past side edges of the paddles, or extends past the side edges of both the gripping members and the paddles.

Abstract: A closing device is provided for an opening in the heart of a patient, the closing device comprising a ring, which can be fastened to the body tissue of the heart in the region of the opening. The ring has a ring opening. The closing device further comprises a closing element, which can be inserted into the ring opening in order to close the ring opening. Furthermore, the closing element can have at least two integrated sensors. The elements provided in or on the closing element can be connected to and can interact with monitoring and control devices in different ways.

Abstract: Prosthetic valves and methods of use of prosthetic valves may be provided. In one implementation, a prosthetic valve may include an annular outer frame formed of struts intersecting at outer frame junctions, an inner frame situated within the outer frame and formed of struts intersecting at inner frame junctions, and a plurality of tissue anchors extending from the outer frame. The junctions along a downstream end of the outer frame may be spaced apart circumferentially from the junctions along a downstream end of the inner frame. The outer frame may include an anchor support strut extending between a downstream junction of the outer frame and a point of connection between one of the tissue anchors and the outer frame. The anchor support strut may be configured for placement parallel to a longitudinal axis of the prosthetic valve.

Abstract: An assembly for reshaping a cardiac ventricle in a patient comprising an implantable device for reshaping a ventricle comprising a tether, a non-implantable tool which is detachably connectable to said implantable device and has a proximal portion and a distal portion opposite to said proximal portion; the implantable device further comprises an active anchor adapted to be detachably connected to the distal portion of the tool; the active anchor comprises an abutment portion adapted to abut against a structure of the ventricle; the active anchor of the implantable device comprises an adjustment device adapted to adjust the tensional state of the tether; the distal portion of the tool comprises an adjustment key adapted to cooperate with the adjustment device of the active anchor; the proximal portion of the tool comprises a maneuvering interface which is operatively connectable to said adjustment key for adjusting the tensional state of the tether by acting on the maneuvering interface of the proximal portion

Abstract: Prosthetic heart valves are described. Prosthetic heart valves can include radially expandable and compressible inner and outer metal frames. The inner frame can be disposed within a lumen of the outer frame and can be coupled to the outer frame. An outflow end of the inner frame can be coupled to and/or located at an outflow end of the outer frame. An end portion of the inner frame can be spaced radially inwardly from an inner surface of the outer frame, such that a radial gap exists between the inner surface of the outer frame and an outer surface of the inner frame. Prosthetic heart valves can further include a plurality of leaflets disposed within and supported by the inner frame, such as by commissure posts of the inner frame.

Abstract: Coaptation assist device for repairing cardiac valves and associated systems and methods are disclosed herein. A coaptation assist device configured in accordance with embodiments of the present technology can include, for example, a fixation member configured to press against cardiac tissue proximate to a native valve annulus, and a stationary coaptation structure extending away from the fixation member. The coaptation structure can include an anterior surface configured to coapt with a first native leaflet during systole and a posterior surface configured to displace at least a portion of a second native leaflet. The device also includes at least one sensor configured to detect parameters associated with at least one of cardiac function and device functionality. The sensors can be pressure sensors configured to detect left atrial pressure and/or left ventricular pressure.

Abstract: Prosthetic heart valves are described. Prosthetic heart valves can include radially expandable and compressible inner and outer metal frames. The inner frame can be disposed within a lumen of the outer frame and can be coupled to the outer frame. An outflow end of the inner frame can be coupled to and/or located at an outflow end of the outer frame. An end portion of the inner frame can be spaced radially inwardly from an inner surface of the outer frame, such that a radial gap exists between the inner surface of the outer frame and an outer surface of the inner frame. Prosthetic heart valves can further include a plurality of leaflets disposed within and supported by the inner frame, such as by commissure posts of the inner frame.

Abstract: Prosthetic heart valves having elastic leaflets and an elastic support structure are described. The support structure can store a load transferred from the leaflets as potential energy and then release it in the form of kinetic energy to exhibit a precursory transition from the closed position to the open position. The support structures can exhibit a sinusoidal movement profile at a base edge during the precursory transition.

Abstract: A method for treating a heart valve involves introducing a delivery catheter into a target ventricle of a heart, the delivery catheter having a coil device disposed at least partially therein, deploying a distal end of the coil device from the delivery catheter, navigating the distal end of the coil device behind a plurality of trabeculae carneae features associated with an inner wall of the ventricle to form one or more coils, and tightening the one or more coils to reduce a diameter of the target ventricle.

Abstract: An easy-to-control interventional instrument delivery device, comprising a core tube (7), a guiding head (2) and a fixing head (3) being fixed onto the core tube (7); the guiding head (2) is fixed at a distal end of the core tube (7), and the fixing head (3) extends from a proximal end side of the core tube (7), an interventional instrument mounting position being located between the guiding head (2) and the fixing head (3); the outer periphery of the interventional instrument mounting position is provided with an axially skiable outer sheathing tube (5), further being provided with a floating limiting strip (1); a proximal end of the floating limiting strip (1) is a starting end (13) that is connected near the fixed head (3), and a distal end is a terminal end (11, 101) that floats between the interventional instrument mounting position and the outer sheathing tube (5).

Abstract: Certain embodiments of the present disclosure provide a prosthetic valve (e.g., prosthetic heart valve) and a valve delivery apparatus for delivery of the prosthetic valve to a native valve site via the human vasculature. The prosthetic valve comprises a frame or stent that comprises multiple cells arranged in unique ways. The prosthetic valve also comprises a leaflet assembly coupled to the frame and having a plurality of leaflets, wherein the leaflets are configured to allow blood to flow through the prosthetic heart valve in one direction from an inflow end portion to an outflow end portion of the frame or stent.

Abstract: A frame for a prosthetic heart valve includes a plurality of strut members arranged to form an annular main body and coupled together by a plurality of pivot joints. The main body of the frame is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration, and the frame has an inflow end and an outflow end. The frame further includes a plurality of leaflet clamps disposed on the exterior of the main body of the frame and coupled to the strut members. The leaflet clamps are movable between an open position corresponding to the collapsed configuration of the frame and a closed position corresponding to the expanded configuration of the frame. Motion of the main body of the frame between the collapsed configuration and the expanded configuration causes corresponding motion of the leaflet clamps between the open position and the closed position.

Abstract: A stented valve suitable for use in body ducts. The valve includes an expandable support structure and an attached flexible membrane that changes shape when the valve opens and closes. The expandable support structure has the shape of a stent with a series of interconnected expandable unit cells and elongated support beams. When the valve is open, body fluid can flow around the membrane and pass through the gap between it and the inner stent surface. In one configuration, a set of two valves is combined with an intermediate inflatable balloon to create a cardiac assist pumping device. In another embodiment, valve closure can be achieved by remotely controlled valve leaflets actuation. A double aorta valve frame is used to accommodate shape and diameter variations of the annulus in an outer valve frame, while the inner valve frame has dimensions for optimized performance of the valve membrane.

Abstract: A method is provided, including (1) identifying the subject as having mitral valve regurgitation; (2) during a medical procedure, in response to identifying the subject as having mitral valve regurgitation, implanting a prosthetic valve at a mitral valve site of the heart; and (3) during the same medical procedure, implanting a therapeutic septal device at a septum of the heart. Other embodiments are also described.

Abstract: The invention relates to a heart valve regurgitation drum and optional closure disk and/or tubular stent to manage and provide levels of intentional regurgitation within an orthogonally delivered transcatheter prosthetic heart valve having a first inner flow control component/valve, a second inner regurgitation control component, and an outer annular support frame having compressible wire cells that facilitate folding flat along the z-axis and compressing the valve vertically along the y-axis, or orthogonally to the central axis of the flow control component, allowing a very large diameter valve to be delivered and deployed to the tricuspid valve from the inferior vena cava or superior vena cava, or trans-atrially to the mitral valve, the valve having a height of about 5-60 mm and a diameter of about 25-80 mm, without requiring an oversized diameter catheter and without requiring delivery and deployment from a catheter at an acute angle of approach.

Abstract: A growth stent and valve and methods for making and using the same. The growth stent and valve may be delivered to treat early stage congenital lesions, while expanding to adult vessel diameters. In selected embodiments, the growth stent and valve can comprise a frame and may have a covering on some portion to prevent blood flow through a wall of the frame. The growth stent and valve advantageously can maintain radial strength across an entire range of diameters necessary to treat a narrowed lesion from birth and childhood through adulthood as the vessels grow over the lifetime of a patient.

Abstract: An implantable prosthetic valve that is radially collapsible to a collapsed configuration and radially expandable to an expanded configuration includes an annular frame including a plurality of angled strut members, and a skirt member secured to the frame. The skirt member includes a plurality of extension portions wrapped around at least one strut member adjacent the extension portions. The prosthetic valve further includes a cord member threaded through at least a portion of the plurality of extension portions to secure the skirt member to the at least one strut member.

Abstract: A prosthetic heart valve may include a stent having an inflow end, an outflow end, a collapsed condition, and an expanded condition. The prosthetic valve may also include a collapsible and expandable valve assembly disposed within the stent and having a plurality of leaflets. The prosthetic valve and/or stent may include features to anchor the prosthetic valve to a native valve annulus and to seal the prosthetic valve with respect to the native valve annulus, such as planar and/or nonplanar annular sealing members coupled to ends of the stent. The stent may include one or more circumferential rows of anchor members or hooks extending radially outwardly from the stent. These hooks may be configured to extend in a particular direction when the stent is in the collapsed condition to facilitate resheathing of the stent if, upon deployment, a user determines the prosthetic heart valve is not positioned optimally.

Abstract: A valved conduit including a bioprosthetic valve, such as a heart valve, and a tubular conduit sealed with a bioresorbable material. The bioprosthetic heart valve includes prosthetic tissue that has been treated such that the tissue may be stored dry for extended periods without degradation of functionality of the valve. The bioprosthetic heart valve may have separate bovine pericardial leaflets or a whole porcine valve. The sealed conduit includes a tubular matrix impregnated with a bioresorbable medium such as gelatin or collagen. The valved conduit is stored dry in packaging in which a desiccant pouch is supplied having a capacity for absorbing moisture within the packaging limited to avoid drying the bioprosthetic tissue out beyond a point where its ability to function in the bioprosthetic heart valve is compromised. The heart valve may be sewn within the sealed conduit or coupled thereto with a snap-fit connection.

Abstract: Several unique intra-cardiac pressure devices, placement catheters, methods of placement and methods of treating heart failure are presented. The intra-cardiac pressure devices presented allow sufficient flow from the left atrium to the right atrium to enable the relief of elevated left atrial pressure and resulting patient symptoms. The intra-cardiac pressure devices are made of a non-braided material.

Abstract: Prosthetic heart valves having elastic leaflets and an elastic support structure are described. The support structure can store a load transferred from the leaflets as potential energy and then release it in the form of kinetic energy to exhibit a precursory transition from the closed position to the open position. The support structures can exhibit a sinusoidal movement profile at a base edge during the precursory transition.

Abstract: The present invention relates to a device for cardiac valve repair, the device comprising: at least one upstream anchoring means adapted to anchor to at least one tissue site, the tissue site located upstream with respect to a heart valve of a patient; and a coaptation structure arranged to extend from the upstream anchoring means, the coaptation structure comprising a free end, wherein the coaptation structure is operable to extend across the heart valve and locate the free end downstream from the heart valve and the coaptation structure operable to coapt with at least one heart valve leaflet of the patient's heart to prevent and/or minimize a backflow of blood. The present invention is suitable for the treatment of heart valves using minimally invasive approaches. Additionally, the present invention is directed to a method of implanting a device for cardiac valve repair in a patient's heart.

Abstract: Prosthetic heart valves are described. Prosthetic heart valves can include radially expandable and compressible inner and outer metal frames. The inner frame can be disposed within a lumen of the outer frame and can be coupled to the outer frame. An outflow end of the inner frame can be coupled to and/or located at an outflow end of the outer frame. An end portion of the inner frame can be spaced radially inwardly from an inner surface of the outer frame, such that a radial gap exists between the inner surface of the outer frame and an outer surface of the inner frame. Prosthetic heart valves can further include a plurality of leaflets disposed within and supported by the inner frame, such as by commissure posts of the inner frame.

Abstract: An implantable prosthetic valve can comprise an annular frame comprising an inflow end and an outflow end and being radially collapsible and expandable between a radially collapsed configuration and a radially expanded configuration, the frame defining an axial direction extending from the inflow end to the outflow end, a leaflet structure positioned within the frame and secured thereto, and an annular outer skirt positioned around an outer surface of the frame, wherein the outer skirt comprises an inflow edge secured to the frame at a first location, an outflow edge comprising a plurality of alternating projections and notches, wherein the projections are secured to the frame at a second location, and the notches are not directly secured to the frame, an intermediate portion between the inflow edge and the outflow edge that comprises a plurality of openings.

Abstract: A method for treating a spinal disorder includes the steps of: disposing an expandable spinal construct in a selected configuration; fixing the spinal construct in the selected configuration with a member; attaching a first end of the spinal construct with tissue; attaching a second end of the spinal construct with tissue; and disengaging the member from the spinal construct to release the spinal construct from the selected configuration. Implants, surgical instruments, systems and methods are disclosed.

Abstract: Devices and methods for the repair of the functioning of heart valves are provided. A device may comprise a first section having a generally spiral shape and a second section connected to the first section. A method involves positioning the device such that chords associated with the heart valve are positioned within the path of the generally spiral shape of the first section and positioning the second section on an opposite side of the heart valve. The first section may be turned in a manner such that the chords move closer to the center of the first section. The first section draws the chords closer together, thereby pulling the valve leaflets closer together in order to facilitate their coaptation and proper closing.

Abstract: Prosthetic heart valve devices with tethered anchors and associated systems and methods are disclosed herein. A heart valve device configured in accordance with embodiments of the present technology can include, for example, a valve support for carrying a prosthetic valve. The valve support can be configured to be implanted at an annulus of a native mitral valve. The device can further include at least one elongated flexible member extending from the valve support in a ventricular direction, and an anchor coupled to the valve support via the elongated flexible member. The anchor can be shaped to wrap around an exterior area of an apical portion of the heart. In addition, the anchor can inhibit retrograde migration of the valve support.

Abstract: Described herein are methods and apparatus for approximating targeted tissue by intertwining two or more sutures together. The sutures are attached to the targeted tissue and routed to a twister device. The twister device secures end portions of the sutures and twists them to intertwine the sutures. Controlling the number of twists provides control over the forces applied to the targeted tissue. In conjunction with visualization feedback, real-time adjustments can be made to achieved targeted results, such as elimination of mitral regurgitation when the disclosed methods and apparatus are applied to mitral valve repair.

Abstract: Features for a heart valve device are described. The device may include a frame with anchors configured to secure the device to tissue. The frame may include a flared end or skirt for additional securement of the implanted device. The device may include a seal such as a barrier and/or cuff for preventing leakage. The device may contract for endovascular delivery of the device to the heart and expand for securement within the heart, such as the within the native mitral valve annulus. The device may include a replacement valve. The valve may have leaflets configured to re-direct blood flow along a primary flow axis.

Abstract: An exemplary valve repair device for repairing a native valve of a patient has a paddle frame, and inner and outer paddle portions formed from a strip of metal fabric. The paddle frame has a round three-dimensional shape. The strip of metal fabric is attached to a closed attachment portion of the paddle frame.

Abstract: A stent (1) used for a heart valve prosthesis and the heart valve prosthesis that includes the stent (1) and is used for heart valve replacement. The stent is configured to support a heart valve (3) and includes, along a longitudinal axis, an inflow section (8), an outflow section (6) and a transition section (7) between the inflow section (8) and the outflow section (6). The stent (1) has a contracted delivery configuration and an expanded deployed configuration. In the expanded deployed configuration, the inflow section (8) defines a concave contour that is complementary to a structure of a native valve annulus. The concave contour enables self-deployment and close adherence of the stent (1), thereby preventing its displacement and perivalvular leakage after implantation.

Abstract: The present disclosure describes devices, systems, and methods for loading, delivering, positioning, and deploying an artificial heart valve device at the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. The valve device is attached at the distal end of the delivery member, and is constrained within a valve cover of an outer sheath. A delivery catheter is configured to advance the valve relative to the outer sheath, and a suture catheter includes sutures/tethers which maintain proximal tension on the valve prior to deployment.

Abstract: A delivery device for an implantable medical device includes an inner shaft with a device-carrying region, an outer shaft surrounding the inner shaft, a sheath at a distal end of the outer shaft, and a sleeve. The outer shaft is movable relative to the inner shaft from an advanced position in which the sheath surrounds the device-carrying region to a retracted position in which the sheath exposes the device-carrying region. The sheath includes a proximal structure having a cylindrical portion between first and second transition zones. The sleeve surrounds the outer shaft and is movable relative to the outer shaft from an advanced position in which a distal end portion of the sleeve surrounds the cylindrical portion to a retracted position in which the distal end portion of the sleeve is spaced proximally from the cylindrical portion.

Abstract: A delivery device includes a central elongate structure including an annular member at the distal end, a sheath, a plurality of tethers extending through the central elongate structure, a handle, and a control on the handle. The handle is connected to the elongate structure, the sheath, and the plurality of tether. The control is configured to move the sheath proximally and distally over the central elongate structure. The annular member includes a plurality of pockets extending radially therearound. Each tether includes a feature on a distal end thereof configured to fit within a pocket of the plurality of pockets to hold the tether in place.

Abstract: In various embodiments, provided herein are methods, devices and systems for transcatheter mitral valve replacement in a double-orifice mitral valve. These methods, devices and systems are used to treat patients with mitral valve disease, particularly those who have had failed edge-to-edge leaflet repair, or patients presently considered anatomically unsuitable for edge-to-edge leaflet repair alone.

Abstract: The present invention provides a modular prosthetic valve device having two or more device modules for percutaneous delivery unassembled at or near the valve implantation site and assembly at least in part using a self-assembly member, and a system and method of folding, delivering and assembling the device. The device modules may include a support structure and a valve module. The valve module has an unassembled, folded delivery configuration, and an unfolded, assembled (via the self-assembly member) working configuration. The valve module may be a single-piece leaflets substructure or a plurality of valve sections. The self-assembly member has a delivery configuration and may be reverted to a preset configuration for valve module assembly. The unassembled valve module may be rolled along its circumferential axis towards its height to a folded diameter equivalent to one rolled leaflet, providing a percutaneous valve device having a smaller delivery diameter than pre-assembled valve devices.

Abstract: A prosthetic heart valve including a stent frame and a valve structure. The valve structure is disposed within a lumen of the stent frame. The stent frame is configured to self-expand from a compressed condition for transluminal delivery. The stent frame has a lattice structure forming a tubular shape defining a circumference and a plurality of closed cells arranged to define a band exhibiting a variable radial stiffness. The prosthesis can be deployed such that the band applies a minimal force on to anatomical locations relating to the heart's conductive pathways. A region of the band otherwise having low radial stiffness is located at or over a conductive pathway upon final implant.

Abstract: A prosthetic mitral valve designed to resemble a patient's nat-ural mitral valve is provided. The prosthetic mitral valve includes an asym-metrical, flexible ring dimensioned to match a native mitral annulus of a pa-tient, two leaflets suspended from the flexible ring, and at least two sets of cords attached to the leaflets and merging into two bundles to be fabricated using pre-operative three-dimensional imaging technologies.

Abstract: A replacement heart valve can have an expandable frame configured to engage a native valve annulus. A valve body can be mounted onto the expandable frame to provide functionality similar to a natural valve. The valve body has an upstream end and a downstream end, and a diameter at the downstream end is greater than a diameter at the upstream end.

Abstract: Embodiments of the present disclosure include a device for repositioning papillary muscles. The device may comprise a band configured to encircle a cluster of papillary muscles. The cluster of papillary muscles may have an outer peripheral boundary defined by the encircling band, and the band may comprise a first end and a second end. The device may further comprise an adjustable clasp coupled to a location proximate the first end of the band. The clasp may be configured to transition from an open configuration to a closed configuration to connect the second end of the band to the first end of the band, thereby forming a loop. The clasp may be selectively actuatable to adjust a length of the loop.

Abstract: This document provides devices and methods for repairing a prolapsing mitral valve leaflet using minimally invasive catheter based approaches. For example, percutaneous procedures that involve folding and securing a segment of a prolapsing leaflet onto or pulling and securing a segment of a prolapsing leaflet through part of the greater mitral valve leaflet are provided. In some cases, artificial chordae are installed to stabilize and maintain desired orientation of the leaflets.