Abstract: Apparatus and methods are described including a medical device (22, 90), and a delivery catheter (24) that is configured deliver the medical device (22, 90) to a portion of subjects body. An overtube (40) is configured to maintain a proximal portion of the medical device (22, 90) in a radially-constrained configuration, during delivery of the medical device (22, 90) to the portion of the subjects body. A string-rod constraining mechanism (41) includes a rod (44) disposed at least partially within the overtube (40), and at least one string (42). The string-rod mechanism (41) maintains a distal portion of the medical device (22, 90) in a radially-constrained configuration, when the overtube (40) is not covering the distal portion of the medical device (22, 90), by the at least one string (42) extending from the distal portion of the medical device to the rod (44). Other applications are also described.

Abstract: Apparatus and methods are described for use with a prosthetic valve (20) that is configured to be deployed within a native atrioventricular valve of a heart of a mammalian subject. A valve frame (22) includes a valve-frame body (24) that is configured to support the prosthetic valve (20) within the native atrioventricular valve. A first set of chord-recruiting arms (34) are configured to extend from the valve-frame body (24) and to curve around the valve-frame body (24) circumferentially in a first circumferential direction. A second set of chord-recruiting arms (34) are configured to extend from the valve-frame body (24) and to curve around the valve-frame body (24) circumferentially in a second circumferential direction that is an opposite direction from the first circumferential direction. Other applications are also described.

Abstract: Apparatus and methods are described including a valve frame defining a frame aperture and at least one arm attached to a portion of the valve frame on a ventricular side of said frame aperture. The at least one arm is configured to extend radially from the portion of the valve frame such that a chord receiving surface of the arm is sized and shaped to deploy among a region of the chords of the native mitral valve. The arm is curved, with an interior of the arm facing a direction in which the valve frame is configured to be rotated during deployment of the prosthetic mitral valve apparatus within the native mitral valve and with the arm having a concavely rounded leading edge facing at least partially in a circumferential direction. Other applications are also described.

Abstract: Apparatus and methods are described herein including an expandable prosthetic mitral valve device that includes a first component configured to be deployed in a left atrium of the subject and a second component configured to be deployed in a left ventricle of the subject. At least one approximating component approximates the first and second components with respect to each other, such that, when the first and said second components are in an approximated configuration with respect to each other, one or more leaflets of the native mitral valve are trapped within the gap between a ventricular part and an annulus part. The approximating component secures the annulus part and the ventricular part in the approximated configuration. Other applications are also described.

Abstract: According to an aspect of some embodiments of the invention, there is provided a method of deploying an expandable prosthetic mitral valve in a subject, the method comprising: deploying a first component of the prosthetic mitral valve in a left atrium; deploying a second component of the prosthetic mitral valve in a left ventricle; and approximating the first and the second components so that leaflets of a native mitral valve are trapped between the first and the second components.

Abstract: Apparatus and methods are described including placing a valve frame within a subject's heart. The valve frame includes a valve frame body that is configured to support the prosthetic valve within the native atrio-ventricular valve, and at least one arm that is configured to extend from a ventricular portion of the valve frame. The at least one arm is deployed among chords of the native atrio-ventricular valve. Subsequently, at least a portion of the valve frame is rotated in a direction in which an interior of the arm faces, such as to modify shapes of the native valve leaflets and the ventricular structures, by recruiting and deflecting at least a portion of the chords. The frame body of the valve frame is then radially expanded, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes. Other applications are also described.

Abstract: Apparatus and methods are described for use with an annuloplasty ring (20), and an atrioventricular valve of a heart of a mammalian subject, the atrioventricular valve including a valve annulus, valve leaflets, chords, and papillary muscles. A plurality of chord-manipulation arms (26) are configured to be deployed among the chords of the atrioventricular valve, and to cause a size of the valve annulus to decrease, by the chord-manipulation arms (26) being rotated such as to twist the native atrioventricular valve and pull the native atrioventricular valve radially inwards, by the chord-manipulation arms (26) deflecting the chords. The chord-manipulation arms (26) are configured to subsequently provide a counterforce against which the annuloplasty ring (20) is pushed, during implantation of the annuloplasty ring (20). Other applications are also described.

Abstract: Apparatus and methods are described including a valve frame defining a frame aperture and at least one arm attached to a portion of the valve frame on a ventricular side of said frame aperture. The at least one arm is configured to extend radially from the portion of the valve frame such that a chord receiving surface of the arm is sized and shaped to deploy among a region of the chords of the native mitral valve. The arm is curved, with an interior of the arm facing a direction in which the valve frame is configured to be rotated during deployment of the prosthetic mitral valve apparatus within the native mitral valve and with the arm having a concavely rounded leading edge facing at least partially in a circumferential direction. Other applications are also described.

Abstract: Apparatus and methods are described including a valve frame configured to support a prosthetic valve within a native atrio-ventricular valve. The valve frame includes a frame body that includes an atrial portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the atrial portion is disposed on an atrial side of the native atrio-ventricular valve, and a ventricular portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the ventricular portion is disposed within a ventricle of the subject. At least one arm is configured to extend from the ventricular portion of the frame body. Other applications are also described.

Abstract: According to an aspect of some embodiments of the invention, there is provided a method of deploying an expandable prosthetic mitral valve in a subject, the method comprising: deploying a first component of the prosthetic mitral valve in a left atrium; deploying a second component of the prosthetic mitral valve in a left ventricle; and approximating the first and the second components so that leaflets of a native mitral valve are trapped between the first and the second components.

Abstract: According to an aspect of some embodiments of the invention, there is provided a method of deploying an expandable prosthetic mitral valve in a subject, the method comprising: deploying a first component of the prosthetic mitral valve in a left atrium; deploying a second component of the prosthetic mitral valve in a left ventricle; and approximating the first and the second components so that leaflets of a native mitral valve are trapped between the first and the second components.

Abstract: Apparatus and methods are described including a valve frame configured to support a prosthetic valve within a native atrio-ventricular valve. The valve frame includes a frame body that includes an atrial portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the atrial portion is disposed on an atrial side of the native atrio-ventricular valve, and a ventricular portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the ventricular portion is disposed within a ventricle of the subject. At least one arm is configured to extend from the ventricular portion of the frame body. Other applications are also described.

Abstract: A method of accessing the ascending aorta via the superior vena cava (SVC) comprising puncturing the adjacent wall regions of the SVC and AA to provide passage from the SVC into the AA.

Abstract: A prosthetic mitral valve with a frame comprises at least one arm shaped to deploy among a region of chordae tendineae of the native mitral valve to deflect these chords in order to pull the native valve leaflets around the frame to avoid paravalvular leaks. The frame may be made from two parts that are connected by sutures. The prosthetic valve may be deployed by a catherer comprising a deployment clamp attached to the valve frame where the deployment clamp is actuable to induce rotation of the frame.

Abstract: A prosthetic mitral valve with a frame comprises at least one arm shaped to deploy among a region of chordae tendineae of the native mitral valve to deflect these chords in order to pull the native valve leaflets around the frame to avoid paravalvular leaks. The frame may be made from two parts that are connected by sutures. The prosthetic valve may be deployed by a catherer comprising a deployment clamp attached to the valve frame where the deployment clamp is actuable to induce rotation of the frame.

Abstract: Methods and devices for augmenting an atrioventricular valve leaflet is disclosed. A method according to an exemplary embodiment includes piercing a leaflet of the valve to at least a portion of the leaflet's thickness to form a pierced section; and extending the leaflet using said pierced section. A device according to an exemplary embodiment of the invention includes a catheter comprising: a longitudinal tube having a lumen; and a cutting element extendable from the lumen. The cutting element is adapted for forming a limited cut in an atrioventricular valve. A device according to another exemplary embodiment of the invention includes a catheter comprising a longitudinal tube having a lumen; a cutting element extendable from the lumen and adapted for forming a cut in a leaflet of an atrioventricular valve; and a frame, configured to attach to the leaflet and stay attached to the leaflet when the heart beats.

Abstract: A device for remodeling atrioventricular valve leaflets including one or more stretching members and one or more leaflet engaging elements, wherein each stretching member includes at least one leaflet engaging element, the leaflet engaging elements are configured to penetrate a valve leaflet, and the stretching members are configured to be positioned externally to a plane of the leaflet when the leaflet engaging elements have penetrated a valve leaflet. A method for remodeling atrioventricular valve leaflets including inserting one or more leaflet engaging elements into an atrioventricular valve leaflet, and using stretching members positioned externally to a plane of the leaflet to apply a stretching force on the atrioventricular valve leaflet. Related apparatus and methods are also described.

Abstract: Disclosed are a method for engaging cardiac valve leaflets, including a) directing a distal end of an elongated catheter body of a leaflet-engaging device into a coronary sinus of a heart, b) passing a first leaflet-engaging component located proximate to the distal end of the elongated catheter body of the leaflet-engaging device through cardiac tissue separating the coronary sinus and a left atrium of the heart to enter a left atrium of the heart, and c) engaging a first cardiac valve leaflet with the first leaflet-engaging component, thereby engaging at least one cardiac valve leaflet. Related apparatus and methods are also described.

Abstract: Methods and devices for augmenting an atrioventricular valve leaflet is disclosed. A method according to an exemplary embodiment includes piercing a leaflet of the valve to at least a portion of the leaflet's thickness to form a pierced section; and extending the leaflet using said pierced section. A device according to an exemplary embodiment of the invention includes a catheter comprising: a longitudinal tube having a lumen; and a cutting element extendable from the lumen. The cutting element is adapted for forming a limited cut in an atrioventricular valve. A device according to another exemplary embodiment of the invention includes a catheter comprising a longitudinal tube having a lumen; a cutting element extendable from the lumen and adapted for forming a cut in a leaflet of an atrioventricular valve; and a frame, configured to attach to the leaflet and stay attached to the leaflet when the heart beats.

Abstract: Disclosed are methods for treatment of cardiac valve including augmenting a cardiac leaflet with the help of a ring associated with a membrane. Also disclosed are methods for treatment of cardiac valves including augmenting the tissue surrounding a cardiac valve, for example with the help of a tubular or annular implant, allowing relocation of the valve. In embodiments, the methods of the present invention improve leaflet coaptation, which in embodiments is useful for treating conditions such as ischemic mitral regurgitation. Also disclosed are devices useful for implementing the methods of the present invention.