Abstract: A tubular system is configured to transluminally deliver an implant comprising a tissue anchor having a coupling head and a distal helical tissue-engaging element, into a heart of a subject. The tissue anchor is slidable through a channel of the system, the channel being slidable within a catheter. An anchor driver is configured, while coupled to the coupling head of the tissue anchor, to drive the tissue anchor through the system and out the system's distal end, to anchor the tissue-engaging element to tissue of the heart. While a first electrode is in contact with the subject and a second electrode is inside the heart of the subject, a control unit receives an electrophysiological signal from the electrodes, and based on the electrophysiological signal, indicates a position of the second electrode inside the heart. Other embodiments are also described.

Abstract: A catheter, advanced toward an anatomical site, has a proximal end and a steerable distal end. An anchor is advanced through the catheter. An anchor driver drives the anchor out of the catheter's distal end, anchoring the anchor at the site. A first constraining member engages tissue, and inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a first axis between the anchor driver's distal end and a site at which the first constraining member engages the tissue. A second constraining member inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a second axis. Other embodiments are also described.

Abstract: An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. A tissue anchor is stored in the anchor-storage zone. The anchor-handing device is configured such that, while the tissue anchor is stored in the anchor-storage zone, the tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening by the element moving in response to the proximally-directed force. Other embodiments are also described.

Abstract: An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. An anchor driver comprises an anchor-engaging head, the anchor-engaging head being dimensioned to be advanceable through the proximal opening toward the anchor-storage zone. A tissue anchor is stored in the anchor-storage zone, and comprises a coupling head configured to be locked to the anchor-engaging head. The tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor by the anchor driver. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening, by moving in response to the proximally-directed force such that at least part of the element protrudes out of the housing. Other embodiments are also described.

Abstract: Systems and apparatuses for use with a guidewire are provided. The systems/apparatuses can include a first housing, shaped to define a first channel through which the guidewire is slidable and a second housing, shaped to define a second channel through which the guidewire is slidable in at least a first direction toward the first housing. The systems/apparatuses can also include a guidewire-engaging element, disposed within the second housing, and configured to inhibit the guidewire from sliding through the second channel in a second direction away from the first housing. A tubular member having a lumen through which the guidewire is slidable and being slidably coupled to the first housing can also be included. Other embodiments are also described.

Abstract: System for use with tissue of a heart comprises a tissue anchor comprising an engaging head that has a coupling eyelet that defines an eyelet plane, and a helical tissue-coupling element, reversibly anchorable to the tissue, and having a central helix axis that lies on the eyelet plane. The system also comprises an anchor driver, having a distal portion that has a casing that defines a slot, the slot defining a slot plane, and dimensioned to receive at least part of the eyelet therein in a manner in which the eyelet plane is coplanar with the slot plane. The anchor driver also comprises a detent, configured to reversibly inhibit movement of the eyelet with respect to the slot. The anchor driver is configured to anchor the tissue anchor to the tissue by rotating the tissue anchor by applying a rotational force to the eyelet. Other embodiments are also provided.

Abstract: An example anchor-manipulation tool includes (i) at a distal portion of the tool, an anchor-engaging element and an actuator, (ii) at an extracorporeal proximal portion of the tool, a controller, and (iii) a flexible longitudinal member extending between the proximal portion and the distal portion. The distal portion of the tool can be transluminally advanced to an anchor that is intracorporeally implanted in a subject. Subsequently, the anchor-engaging element can be engaged with an eyelet defined by a head of the anchor. Subsequently, the controller can be used to transition the tool into an articulatably-coupled state in which: (i) the eyelet at least in part inhibits movement of the anchor-engaging element away from the anchor, and (ii) the distal portion of the anchor-manipulation tool is deflectable with respect to the anchor. Subsequently, the anchor can be de-anchored by using the anchor-manipulation tool to apply a de-anchoring force to the eyelet.

Abstract: An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. An anchor driver comprises an anchor-engaging head, the anchor-engaging head being dimensioned to be advanceable through the proximal opening toward the anchor-storage zone. A tissue anchor is stored in the anchor-storage zone, and comprises a coupling head configured to be locked to the anchor-engaging head. The tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor by the anchor driver. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening, by moving in response to the proximally-directed force such that at least part of the element protrudes out of the housing. Other embodiments are also described.

Abstract: A method is described for use with a heart of a subject, the heart having a valve and an atrium upstream of the valve. The method includes transluminally advancing multiple tissue anchors to the atrium; and securing an elongate contraction member at least partly around an annulus of the valve by anchoring the tissue anchors to the annulus, such that the tissue anchors are distributed along the elongate contraction member. The method further includes subsequently contracting the annulus by applying tension the elongate contraction member, such that a radiopaque indicator that is disposed within the heart and that is coupled to the contraction member undergoes a conformational change in response to the tension. The conformational change of the radiopaque indicator within the heart is observed, and the tension is adjusted responsively to the observed conformational change. Other embodiments are also described.

Abstract: An anchor-storage device comprises (i) a housing, shaped to define a channel having an anchor-storage zone and an opening configured to provide access for an anchor driver to the anchor-storage zone; and (ii) a retaining member. A tissue anchor is stored in the anchor-storage zone and is slidable through the channel. The retaining member (a) has a retaining state in which the retaining member is configured to retain the tissue anchor in the anchor-storage zone, and (b) is configured, by moving in response to a proximally-directed force applied to the tissue anchor, to allow the tissue anchor to leave the anchor-storage zone in response to the proximally-directed force. The proximally-directed force is greater than a pre-determined threshold force. Other embodiments are also described.

Abstract: An anchor includes (a) an anchor head; and (b) a tissue-engaging member extending distally away from the anchor head until a distal tip of the tissue-engaging member, and configured to anchor the anchor to tissue. An anchor driver can include (a) a longitudinal shaft, having a flexible distal portion and a distal end; (b) a deployment element at the distal end of the shaft, reversibly lockable to the anchor head, and reversibly movable between (i) a locked state that retains locking between the deployment element and the anchor head, and (ii) an unlocked state that unlocks the deployment element from the anchor head; and (c) a tissue-piercing lance, reversibly movable between (i) an extended state in which the lance extends distally from the shaft past the distal tip of the anchor, and retains the deployment element in the locked state, and (ii) a retracted state in which the deployment element automatically moves into the unlocked state.

Abstract: A fluid device includes a base material including a flow path through which a solution flows and a first facing surface, a treatment substrate including a second facing surface which faces the first facing surface and in which a treatment unit which comes in contact with the solution and treats the solution is provided, and a sealing portion sandwiched between the first facing surface and the second facing surface, in which a treatment space surrounding the treatment unit with the sealing portion when viewed from a plate thickness direction and connected to the flow path is provided between the treatment substrate and the base material.

Abstract: A catheter, advanced toward an anatomical site, has a proximal end and a steerable distal end. An anchor is advanced through the catheter. An anchor driver drives the anchor out of the catheter's distal end, anchoring the anchor at the site. A first constraining member engages tissue, and inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a first axis between the anchor driver's distal end and a site at which the first constraining member engages the tissue. A second constraining member inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a second axis. Other embodiments are also described.

Abstract: Apparatus is provided including a percutaneously-implantable implant and an adjustment device. The adjustment device can comprise an adjustment mechanism, coupled to the implant, and configured to change a dimension of the implant upon actuation of the adjustment mechanism and a lock. The adjustment device can have a locked state in which the lock inhibits actuation of the adjustment mechanism and an unlocked state in which the adjustment mechanism is actuatable. The adjustment device can be reversibly movable between the locked state and the unlocked state. The apparatus can include a longitudinal guide member and an adapter. An unlocking mechanism can be configured such that, while the adapter is coupled to the adjustment device, actuation of the unlocking mechanism moves the lock between the locked state and the unlocked state. Other applications are also described.

Abstract: A catheter, advanced toward an anatomical site, has a proximal end and a steerable distal end. An anchor is advanced through the catheter. An anchor driver drives the anchor out of the catheter's distal end, anchoring the anchor at the site. A first constraining member engages tissue, and inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a first axis between the anchor driver's distal end and a site at which the first constraining member engages the tissue. A second constraining member inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a second axis. Other embodiments are also described.

Abstract: Systems and apparatuses for use with a guidewire are provided. The systems/apparatuses can include a first housing, shaped to define a first channel through which the guidewire is slidable and a second housing, shaped to define a second channel through which the guidewire is slidable in at least a first direction toward the first housing. The systems/apparatuses can also include a guidewire-engaging element, disposed within the second housing, and configured to inhibit the guidewire from sliding through the second channel in a second direction away from the first housing. A tubular member having a lumen through which the guidewire is slidable and being slidably coupled to the first housing can also be included. Other embodiments are also described.

Abstract: An example anchor-manipulation tool includes (i) at a distal portion of the tool, an anchor-engaging element and an actuator, (ii) at an extracorporeal proximal portion of the tool, a controller, and (iii) a flexible longitudinal member extending between the proximal portion and the distal portion. The distal portion of the tool can be transluminally advanced to an anchor that is intracorporeally implanted in a subject. Subsequently, the anchor-engaging element can be engaged with an eyelet defined by a head of the anchor. Subsequently, the controller can be used to transition the tool into an articulatably-coupled state in which: (i) the eyelet at least in part inhibits movement of the anchor-engaging element away from the anchor, and (ii) the distal portion of the anchor-manipulation tool is deflectable with respect to the anchor. Subsequently, the anchor can be de-anchored by using the anchor-manipulation tool to apply a de-anchoring force to the eyelet.

Abstract: Apparatus for use with a guidewire is provided, the apparatus including (1) a first housing, shaped to define a first channel through which the guidewire is slidable; (2) a second housing, shaped to define a second channel through which the guidewire is slidable in at least a first direction toward the first housing; (3) a guidewire-engaging element, disposed within the second housing, and configured to inhibit the guidewire from sliding through the second channel in a second direction away from the first housing; and (4) a tubular member, (a) shaped to define a lumen therethrough, through which the guidewire is slidable, and (b) coupled to the second housing and slidably coupled to the first housing. Other embodiments are also described.

Abstract: A first element (91) includes a first arm (92) and a second arm coupled thereto and having a concavity (103) facing the first arm and defining a space (96). In an open state, a tissue anchor portion (46) moves into the space through a gap between distal portions (94) of the first and second arms. In the closed state, the anchor portion is not movable through the gap. A second element (82) is movable with respect to the first element, such that, while the portion (46) of the anchor (40) is within the space, and the first element is in the closed state, in a first position of the second element, the portion of the anchor is movable within the space, and in a second position of the second element, the second element applies torque to the anchor by rotating the second element. Other embodiments are also described.

Abstract: Apparatus is provided, the apparatus comprising (i) a housing (22, 222), shaped to define a channel (24, 224) having an anchor-storage zone (26, 226) and an opening (28, 228) configured to provide access for an anchor driver (60) to the anchor-storage zone; (ii) a tissue anchor (40), stored in the anchor-storage zone and slidable through the channel; and (iii) a retaining member (30, 230). The retaining member (a) has a retaining state in which the retaining member is configured to retain the tissue anchor in the anchor-storage zone, and (b) is configured, by moving in response to a proximally-directed force applied to the tissue anchor, to allow the tissue anchor to leave the anchor-storage zone in response to the proximally-directed force. The proximally-directed force is greater than a pre-determined threshold force. Other embodiments are described.