Abstract: Apparatus is provided, including one or more valve support guide members configured to be delivered to one or more commissures of a native atrioventricular valve of a patient, one or more valve support anchors configured to be anchored to the one or more commissures of the native valve, a prosthetic valve support advanceable toward the native valve along the one or more valve support guide members and anchored to the native valve at least the one or more commissures, and a prosthetic valve configured to be coupled to the valve support. Other applications are also described.

Abstract: Apparatus and methods are described including a prosthetic valve support (40) configured to be placed at a patient's native atrioventricular valve annulus. The valve support defines an annular element (44) that defines an inner cross-sectional area thereof. An expandable prosthetic valve (80) is placed into the patient's ventricle, the prosthetic valve including an expandable frame (79) and prosthetic valve leaflets (82) coupled to the frame. When the frame is in a non-constrained state thereof, a cross-sectional area of the frame, along at least a given portion L of the frame's length, is greater than the cross-sectional area defined by the annular element. The prosthetic valve is couplable to the prosthetic valve support at any location along the portion, by the frame being expanded when the location along the portion is aligned with the annular element. Other applications are also described.

Abstract: Apparatus and methods are described, including one or more valve support guide members that are delivered to one or more commissures of a native atrioventricular valve of a patient. A prosthetic valve support is advanced toward the native valve along the one or more valve support guide members and placed at the native valve. A prosthetic valve is coupled to the valve support. One or more sealing elements facilitate sealing of an interface between the prosthetic valve support and the native valve. Other applications are also described.

Abstract: Apparatus is provided for use with a native valve of a heart of a subject, the apparatus including (1) an annular upstream support portion, configured to be transluminally placed against an atrial surface of the native valve; (2) a tissue-engaging element that includes a coupling portion configured to be transluminally coupled to tissue in a ventricle of the heart; (3) an elastically-stretchable holding element, configured to secure the upstream support portion against the atrial surface by elastically coupling the coupling portion to the upstream support portion; and (4) a prosthetic valve, configured to be transluminally delivered to the native valve and intracorporeally coupled to the upstream support portion subsequently to the securing of the upstream support portion against the atrial surface. Other embodiments are also described.

Abstract: Apparatus is described for use with a native heart valve of a subject, the apparatus including (1) a prosthetic valve support, comprising an upstream support portion, the upstream support portion having (a) a compressed configuration and an uncompressed configuration in which the upstream support portion has an inner perimeter that defines an opening; and (2) a prosthetic valve, advanceable into the opening defined by the upstream support portion, and intracorporeally couplable to the upstream support portion by being expanded within the opening defined by the upstream support portion, the apparatus being configured such that, when the prosthetic valve is expanded within the opening defined by the upstream support portion, the expansion of the prosthetic valve is restricted by the inner perimeter of the upstream support portion, without causing the prosthetic valve support to apply a radially-expansive force to the native annulus. Other embodiments are also described.

Abstract: Apparatus is provided for use with a prosthetic valve for implantation at a native valve of a subject, the native valve including at least one native leaflet, the apparatus including (1) a prosthetic valve support, including (a) an upstream support portion, being configured to be placed against an upstream side of the native valve, and having an inner perimeter that defines an opening that is configured to receive the prosthetic valve, and (b) at least one clip (i) comprising at least two clip arms and a clip-controller interface, the clip-controller interface being coupled to at least one of the clip arms, and (ii) being configured to be coupled to a native leaflet of the native valve; and (2) at least one clip controller, reversibly couplable to the clip-controller interface, and configured to facilitate opening and closing of the clip. Other embodiments are also described.

Abstract: Apparatus is provided, including: (1) a delivery tube, transluminally advanceable to the heart of the subject; (2) a prosthetic valve support, configured to support a prosthetic valve at a native valve of the heart, and including an upstream support portion, the upstream support portion: (A) having a working configuration in which it is generally annular and (B) having a delivery configuration in which it defines a channel, and is configured to be disposed within the delivery tube; (3) a tissue anchor, slidable through the channel; and (4) an anchor driver. The anchor driver is slidable within the delivery tube and the channel, and configured to anchor the upstream support portion to tissue of the heart by driving the tissue anchor through the upstream support portion and into the tissue, while at least part of the upstream support portion is disposed within the delivery tube.

Abstract: Apparatus for regulating blood flow of a subject is provided, the apparatus comprising a prosthetic valve that comprises a tubular element, shaped to define a lumen therethrough; and a valve member, configured to be coupled to the tubular element and to be disposed within the lumen. The prosthetic valve has (1) a compressed configuration in which the lumen has a compressed width, the valve member is generally cylindrical, and the prosthetic valve is configured to be percutaneously delivered into the subject, and (2) an expanded configuration in which the lumen has an expanded width that is greater than the compressed width, and the valve member is generally disc-shaped, is coupled to the tubular element, and is disposed within the lumen. Other embodiments are also described.

Abstract: Apparatus and methods are described including a prosthetic valve support (40) configured to be placed at a patient's native atrioventricular valve annulus. The valve support defines an annular element (44) that defines an inner cross-sectional area thereof. An expandable prosthetic valve (80) is placed into the patient's ventricle, the prosthetic valve including an expandable frame (79) and prosthetic valve leaflets (82) coupled to the frame. When the frame is in a non-constrained state thereof, a cross-sectional area of the frame, along at least a given portion L of the frame's length, is greater than the cross-sectional area defined by the annular element. The prosthetic valve is couplable to the prosthetic valve support at any location along the portion, by the frame being expanded when the location along the portion is aligned with the annular element. Other applications are also described.