Abstract: A prosthetic valve leaflet is placed across a bar, and the bar is positioned such that the leaflet drapes over the bar and blocks a beam of light emitted by a light source. While the leaflet remains draped over the bar, the bar is elevated at least until the leaflet stops blocking the beam. An elevation of the bar from the beam at which the leaflet stopped blocking the beam is identified. Other embodiments are also described.

Abstract: A delivery tool includes a nosepiece that is fixed to a shaft, and distal to an implant, and an expandable element proximal to the nosepiece. Maximally-expanded, the expandable element (i) has an expanded external diameter at its widest part that is smaller than the expanded internal diameter of a lumen of the frame of the implant, (ii) tapers proximally away from the widest part and from the nosepiece, and (iii) is dimensioned to slide proximally through the lumen of the implant in its expanded state, between leaflets of the implant, and out of the lumen. When non-expanded, the widest part of the expandable element has a non-expanded external diameter that is smaller than the expanded external diameter of the expandable element. In a compressed state of the implant a portion of the expandable element is disposed within the lumen of the frame. Other applications are also described.

Abstract: A method includes percutaneously advancing an implant to a native heart valve of a subject, the implant being housed in a compressed state within a delivery tool. Next, the method includes unhousing a longitudinally-intermediate portion of the implant, the longitudinally-intermediate portion being longitudinally between a longitudinally-proximal portion of the implant and a longitudinally distal portion of the implant. Subsequently, the longitudinally-proximal portion of the implant is unhoused. Subsequently, the longitudinally-distal portion of the implant is unhoused. Other applications are also described.

Abstract: An anchoring device including a finger-mountable work channel defining assembly defining a finger mounting axis and a work channel axis angled with respect to the finger mounting axis, the finger-mountable work channel defining assembly defining an aperture lying generally in an aperture plane angled with respect to the finger mounting axis and with respect to the work channel axis, an anchor insertion assembly arranged for limited axial displacement along the work channel axis with respect to the aperture so as to intersect the aperture plane and an anchor assembly including at least an anchoring portion and a flexible elongate portion attached thereto, the anchoring portion having a pre-anchoring operative orientation and an anchoring operative orientation.

Abstract: Prosthetic valves and methods of use of prosthetic valves may be provided. In one implementation, a prosthetic valve for implantation within a native heart valve may be provided. The prosthetic valve may include an annular valve body having atrial anchoring arms and ventricular anchoring legs extending therefrom. The atrial anchoring arms and the ventricular anchoring legs may be configured for independent outward radial deflection. In some embodiments, at least one atrial anchoring arm may include first and third arm segments configured to extend in upstream directions and a second arm segment configured to extend in a downstream direction, the second arm segment situated between the first and third arm segments. The terminal end of the at least one atrial anchoring arm may be configured to be situated upstream from the rest of the arm when the prosthetic valve is radially-expanded.

Abstract: An implant includes a prosthetic valve and is transitionable from a compressed to an expanded state. The implant includes a frame assembly including a plurality of struts that collectively define an upstream-frame-assembly-perimeter at an upstream end of the frame assembly and a downstream-frame-assembly-perimeter at a downstream end of the frame assembly. The frame assembly includes a valve frame that defines a lumen, and one or more appendages disposed at and extending in a downstream direction from the downstream-frame-assembly-perimeter. A plurality of prosthetic leaflets are disposed within the valve frame lumen and facilitate one-way upstream-to-downstream fluid flow through the lumen. The implant includes a fabric and, in the expanded state of the implant, the fabric obscures the one or more appendages and defines a downstream perimeter of the fabric at a downstream end of the implant. Additional embodiments are described.

Abstract: An expandable prosthetic valve for implantation within a native heart valve may be provided. The prosthetic valve may include an expandable annular valve body. The valve body may include an atrial inlet opening and a ventricular outlet opening. The valve body may additionally include a plurality of tissue anchors extending from the valve body. The prosthetic valve may additionally include a flexible annular protective sleeve positioned about the rim of the valve body outlet opening and affixed to the outlet opening.

Abstract: A tool (410) for use with an implant (20) includes a housing (426) and a controller (440). The housing includes a tubular wall (428) that circumscribes a longitudinal axis; is dimensioned to house at least part of the implant; and defines a track (430) that follows a generally-helical path around the longitudinal axis. The controller includes a rod (442) that extends from a proximal part of the tool to the housing; and an actuator (444). The actuator is fixedly coupled to the rod, includes an engaging element (446) that engages the track, and is rotatable with respect to the housing. The controller and the housing mechanically cooperate such that rotation of the actuator with respect to the housing slides the housing longitudinally with respect to the actuator. Other embodiments are also described.

Abstract: An arthroscopic bone channel forming and suturing system useful following formation of a first and a second generally straight channel in a bone, the second channel not intersecting the first channel, the system including a curved bone puncture needle configured to be insertable into the first channel, a curved needle driving assembly configured to manipulate the curved needle to form a curved junction between the first channel and the second channel, a suture snare wire assembly configured to insert a suture snare wire to a suture snare wire pick-up location via the second channel in the bone and a coordinated multi-function driving assembly operative to operate the curved needle driving assembly and the suture snare wire assembly in coordinated operation to cause the suture snare wire to be pulled from the suture pick up location and through the first channel via the junction.

Abstract: A delivery tool includes a delivery capsule, disposed at a distal portion of the tool. The delivery capsule includes a proximal capsule-portion dimensioned to house a first part of an implant, and a distal capsule-portion dimensioned to house a second part of the implant; and an extracorporeal control portion, disposed at a proximal portion of the tool, the control portion including one or more controllers and one or more locks. The controllers are operatively coupled to the proximal and distal capsule-portions such that the proximal and distal capsule-portions are movable with respect to the implant via actuation of the controllers. The tool has sequential states in which movement of the proximal and distal capsule-portions is variously inhibited or facilitated.

Abstract: A prosthetic valve for implantation within a native heart valve may be provided. The prosthetic valve may include an annular outer frame having a plurality of ventricular anchoring legs extending therefrom, as well as an inner frame having a plurality of atrial anchoring arms extending therefrom. A portion of each ventricular anchoring leg may be configured to overlap with a portion of each atrial anchoring arm in a common lateral plane. As a result, a prosthetic valve with a reduced axial length may be provided.

Abstract: An expandable prosthetic valve for implantation within a native heart valve may be provided. The prosthetic valve may include an expandable annular valve body. The valve body may include an atrial inlet opening and a ventricular outlet opening. The valve body may additionally include a plurality of tissue anchors extending from the valve body. The prosthetic valve may additionally include a flexible annular protective sleeve positioned about the rim of the valve body outlet opening and affixed to the outlet opening.

Abstract: A valve body circumscribes a longitudinal axis and defines a lumen along the axis. Upstream arms are coupled to the valve body, and extend radially outward from the valve body to respective arm-tips. Downstream legs are coupled to the valve body, and extend radially outward from the valve body and toward the plurality of arms. A flexible pouch extends radially outward from the valve body. The arms and the legs narrow the pouch therebetween to form a narrowed portion of the pouch, thereby defining, in an interior space of the pouch: (a) an inner portion, radially inward from the narrowed portion, and in fluid communication with the lumen, and (b) an outer portion, radially outward from the narrowed portion, and in fluid communication with the inner portion via the narrowed portion. Other embodiments are also described.

Abstract: Prosthetic valves and methods of using prosthetic valves may be provided. In one implementation, an expandable annular valve body may include a plurality of atrial anchoring arms and ventricular anchoring legs extending radially outward therefrom. At least one atrial anchoring arm may include a rigid portion and a flexible portion positioned radially outwards from the rigid portion. At least one atrial anchoring arm and at least one ventricular anchoring leg may be arranged such that a proximal section of the flexible portion of the at least one atrial anchoring arm and a terminal leg end of the at least one ventricular anchoring leg are substantially equidistant from a longitudinal axis extending through the center of the annular valve body.

Abstract: A prosthetic valve configured for implantation within a native valve may be provided. The prosthetic valve may include an expandable valve body having an inner lumen extending along a longitudinal axis of the valve body. The prosthetic valve may additionally include a plurality of ventricular tissue anchors configured to extend from the valve body to ventricular anchor distal ends, as well as a plurality of atrial tissue anchors configured to extend from the valve body to atrial anchor distal ends. Each atrial tissue anchor may include a rigid portion, and a flexible portion situated between a distal end of the rigid portion and the atrial anchor distal end. The ventricular anchor distal end of a ventricular tissue anchor and the distal end of the rigid portion of an atrial tissue anchor may be configured to be equidistant from the longitudinal axis of the valve body.

Abstract: Implant deployment device for delivering and deploying an implant. Includes: deployment device body for pushing implant in subject's blood vessel, across an interatrial septum and into subject's heart left atrium; and a handle operatively connected to deployment device and having controls assigned to selectively operate positioning of the deployment device, to facilitate determining compression extent of an implant body, and detaching of deployment device from the implant. Also disclosed are: a method for fixating an elongated implant across an organ wall in a subject's body, and a method for sealing a wall opening in a septal wall in a subject's body.

Abstract: A prosthetic valve for implantation within a native mitral valve may be provided. The prosthetic valve may include an annular valve body. The prosthetic valve may also include a plurality of tissue anchors arranged about the valve body and configured to extend from connection points on the valve body. The prosthetic valve may also include at least one protective fabric covering extending over each of the connection points between each tissue anchor and the valve body.

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: Prosthetic valves and methods of use of prosthetic valves may be provided. In one implementation, a method of implanting a prosthetic valve within a native heart valve may be provided. The method may include delivering the prosthetic valve into a heart chamber while the prosthetic valve is constrained in a radially-contracted delivery configuration. The method may also include unconstraining ventricular tissue anchors and atrial tissue anchors of the prosthetic valve while maintaining an annular valve body of the prosthetic valve in the delivery configuration. The method may also include unconstraining the annular valve body from the delivery configuration while the unconstrained atrial tissue anchors and ventricular tissue anchors are positioned within an atrium and a ventricle, respectively. Unconstraining the annular valve body may decrease a longitudinal distance between the ventricular tissue anchors and atrial tissue anchors to secure the prosthetic valve within the native heart valve.

Abstract: Prosthetic valves and methods of implanting prosthetic valves may be provided, including a prosthetic valve for implantation within a native heart valve. The prosthetic valve may include an annular valve body, a plurality of atrial anchoring arms, and a plurality of ventricular anchoring legs. The arms and legs may extend radially outward from the annular valve body and may each include a native valve tissue engaging portion. The arms may be angularly offset from the legs, with the tissue engaging portion of each arm and each leg arranged such that when the arms and legs are positioned on opposing sides of native heart valve tissue, the native heart valve tissue may assume a serpentine arrangement between the arms and the legs.