Abstract: A system for use at an annulus of a valve of a heart of a subject comprises an implant and an implant-positioning device. The implant comprises (i) a wire; (ii) multiple anchors, slidably mounted in series along the wire, each of the anchors having: a slot through which the wire is threaded, and a pointy front end; and (iii) multiple tubes, the wire being threaded through each of the tubes such that the multiple tubes are slidably mounted on the wire alternatingly with the multiple anchors. The implant-positioning device is configured to implant the implant in the heart with the wire positioned along the annulus by, for each of the anchors: (i) positioning the anchor at the annulus, and (ii) using a deployment mechanism of the implant-positioning device, driving the pointy front end of the anchor into the annulus. Other embodiments are also described.

Abstract: A method of treating a native mitral valve without open-heart surgery is disclosed. An expandable prosthesis includes an anchoring portion and an occluding member coupled to the anchoring portion. The prosthesis is loaded into a distal end portion of a delivery catheter and is advanced through a femoral vein and through a pre-made puncture in an atrial septum. The anchoring portion self-expands within the left atrium for anchoring the occluding member in a fixed position. The anchoring portion is preferably a laser cut structure that conforms to the left atrium and uniformly distributes anchoring forces within the left atrium. After deployment, the occluding member prevents blood from flowing from the left ventricle to the left atrium during systole. The occluding member is preferably made from a flexible material, such as pericardial tissue.

Abstract: Mitral valve regurgitation can be ameliorated by creating one passageway between the right atrium and the left ventricle at a portion of the tricuspid annulus that is directly above the interventricular septum and creating another passageway through an outer wall of the left ventricle near at least one of the left-ventricular papillary muscles. A first support member is positioned within the right atrium in contact with a septal portion of the tricuspid annulus, and a support plate is positioned against the outer wall of the left ventricle adjacent to the second passageway. The support plate is pulled towards the first support member using a tether under tension that runs between the first support plate and the first support member and passes through both passageways. And the tension in the tether moves the roots of the chordae closer to the mitral valve, which ameliorates the mitral valve regurgitation.

Abstract: Prosthetic valve delivery assemblies including a prosthetic heart valve and a delivery apparatus. The prosthetic heart valve includes a frame having posts extending from a terminal outflow end of the frame and a valve structure disposed within the frame. The delivery apparatus includes an inner shaft including a valve connection portion having recesses configured to receive the posts of the frame of the prosthetic heart valve, an outer shaft including a valve sheath for retaining the prosthetic valve in a radially compressed state and retaining the posts within the recesses, and a handle including a control knob for moving the valve sheath proximally and distally relative to the handle. The control knob is seated within the handle housing such that the housing partially covers a circumferentially extending outer surface of the control knob.

Abstract: Prosthetic valve delivery assemblies including a prosthetic heart valve and a delivery apparatus. The prosthetic heart valve includes a frame having posts extending from a terminal outflow end of the frame and a valve structure disposed within the frame. The delivery apparatus includes an inner shaft including a valve connection portion having recesses configured to receive the posts of the frame of the prosthetic heart valve, an outer shaft including a valve sheath for retaining the prosthetic valve in a radially compressed state and retaining the posts within the recesses, and a handle including a control knob for moving the valve sheath proximally and distally relative to the handle. The control knob is seated within the handle housing such that the housing partially covers a circumferentially extending outer surface of the control knob.

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 delivery apparatus is particularly suited for advancing a prosthetic heart valve through the aorta (i.e., in a retrograde approach) for replacing a diseased native aortic valve. The delivery apparatus in particular embodiments is configured to deploy a prosthetic valve from a delivery sheath in a precise and controlled manner at the target location within the body.

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 delivery apparatus is particularly suited for advancing a prosthetic heart valve through the aorta (i.e., in a retrograde approach) for replacing a diseased native aortic valve. The delivery apparatus in particular embodiments is configured to deploy a prosthetic valve from a delivery sheath in a precise and controlled manner at the target location within the body.

Abstract: Using a catheter, a device is delivered to the heart of a subject. The device includes a cord and multiple anchors distributed along the cord. Subsequently, the device is arranged in an arrangement at the tissue such that the cord is positioned and laid out correspondingly to the tissue. While the device remains in the arrangement, (i) a first subset of the anchors which are positioned for successful anchoring is identified, and (ii) subsequent to the identifying, for each of the anchors of the first subset, a respective anchor launcher is actuated to drive the anchor into the tissue. Subsequently, for each of the anchors that remain not driven into the tissue, (i) the anchor is positioned for successful anchoring, and (ii) a respective anchor launcher is actuated to drive the anchor into the tissue. Other embodiments are also disclosed.

Abstract: A system for use at an annulus of a valve of a heart of a subject comprises an implant and an implant-positioning device. The implant comprises (i) a wire; (ii) multiple anchors, slidably mounted in series along the wire, each of the anchors having: a slot through which the wire is threaded, and a pointy front end; and (iii) multiple tubes, the wire being threaded through each of the tubes such that the multiple tubes are slidably mounted on the wire alternatingly with the multiple anchors. The implant-positioning device is configured to implant the implant in the heart with the wire positioned along the annulus by, for each of the anchors: (i) positioning the anchor at the annulus, and (ii) using a deployment mechanism of the implant-positioning device, driving the pointy front end of the anchor into the annulus. Other embodiments are also described.

Abstract: A device (e.g., an annulus-constricting device) with N anchors may be affixed to a cardiac valve annulus as follows. First, the device is delivered to the vicinity of the annulus via a catheter. Next, the position and layout of the device is adjusted via the catheter. Next, only those anchors which are properly positioned are driven into the annulus or tissue adjacent to the annulus. The remaining anchors remain unlaunched at this point. The unlaunched anchors are subsequently moved into a good position using either a manipulating tool or catheter-steering techniques, after which they are driven into the annulus or tissue adjacent to the annulus.

Abstract: A heart valve annulus repair device having a tissue engaging member and a plurality of anchors. The tissue engaging member includes a loop of wire. Each of the anchors has a pointy front end and a back end and a slot that runs in a front-to-back direction. The anchors are distributed about the loop of wire with the front ends of the plurality of anchors facing the heart valve annulus and with the loop of wire passing through the slots. The device further includes means for implanting the anchors into the heart valve annulus tissue so that the tissue engaging member becomes affixed to the heart valve annulus.

Abstract: A delivery assembly includes a prosthetic device, a catheter shaft, a release wire, a first line, and a second line. The prosthetic device has a first arm and a second arm. The release wire extends through the catheter shaft. The first line includes a first loop. The first line extends from the catheter shaft, through the first arm of the prosthetic device, and to the release wire, where the release wire extends through the first loop. The second line includes a second loop. The second line extends from the catheter shaft, through the second arm of the prosthetic device, and to the release wire, where the release wire extends through the second loop.

Abstract: An implant may be affixed to a cardiac valve annulus by an apparatus that includes a catheter with a first actuatable bending section and a support structure affixed to the distal end of the catheter. Support arms extend distally beyond the support structure. In some embodiments, a shaft with a second actuatable bending section is permanently positioned between the support arms, and an inflatable balloon surrounds at least a portion of the shaft. In other embodiments, a subassembly that includes a shaft with a second actuatable bending section and an inflatable balloon is slidably mounted so that it can move from an initial position that is spaced apart from the support structure to a second position where the balloon is between the at least four support arms. In either case, actuating the second bending section when the balloon is inflated will move the support arms that support the implant.

Abstract: A method of treating a defective heart valve includes inserting a delivery catheter through a small incision in a patient's groin, wherein the delivery catheter has a prosthetic device positioned along a distal end. The prosthetic device includes an insert member and an anchoring member. The insert member self-expands to plug gaps between leaflets of the heart valve. The anchoring member is preferably a stent connected to the insert member by at least one elongate member. The stent is deployed within an adjacent blood vessel for anchoring the insert member. After deployment of the prosthetic device, the leaflets of the heart valve form a tight seal against the insert member for preventing regurgitation when the leaflets are closed and wherein blood passes through the insert member when the leaflets are open.

Abstract: Delivery assemblies including a prosthetic heart valve and a delivery apparatus are disclosed. The prosthetic heart valve includes a frame having posts extending from a terminal outflow end of the frame and a valve structure disposed within the frame. The delivery apparatus includes an inner shaft including a valve connection portion having recesses configured to receive the posts of the frame of the prosthetic heart valve, an outer shaft including a valve sheath for retaining the prosthetic valve in a radially compressed state and retaining the posts within the recesses, and a handle including a control knob for moving the valve sheath proximally and distally relative to the handle. The control knob is seated within the handle housing such that the housing partially covers a circumferentially extending outer surface of the control knob.

Abstract: A handle for a prosthetic heart valve delivery apparatus includes a housing, a motorized mechanism, and a holding mechanism. The housing is configured to be hand-held by a user and includes a distal opening. The motorized mechanism is disposed within the housing and is configured to be releasably coupled to a proximal end portion of a first shaft of the prosthetic heart valve delivery apparatus. When actuated, the motorized mechanism is configured to rotate the first shaft relative to the housing. The holding mechanism is disposed inside the housing and is configured to engage a proximal end portion of a second shaft of the prosthetic heart valve delivery apparatus such that the second shaft is axially and rotationally fixed relative to the housing, and the first shaft extends through the second shaft.

Abstract: An assembly for replacement of a native aortic heart valve includes a radially collapsible prosthetic heart valve and a delivery apparatus. The prosthetic heart valve includes an annular frame with attachment posts, wherein each of the posts has an axial post portion and a transverse post portion having a greater circumferential dimension than the axial post portion. The delivery apparatus includes an inner shaft with a valve connection portion for releasably coupling to the attachment posts and an outer shaft having a sheath for maintaining the prosthetic heart valve in a radially compressed state. Rotation of a control knob on a handle causes the sheath to retract for uncovering a portion of the prosthetic heart valve. Further rotation of the control knob allows the posts to decouple from the delivery apparatus such that the prosthetic heart valve self-expands to a fully expanded state.

Abstract: A delivery assembly includes a prosthetic device, a catheter shaft, a release wire, a first line, and a second line. The prosthetic device has a first arm and a second arm. The release wire extends through the catheter shaft. The first line includes a first loop. The first line extends from the catheter shaft, through the first arm of the prosthetic device, and to the release wire, where the release wire extends through the first loop. The second line includes a second loop. The second line extends from the catheter shaft, through the second arm of the prosthetic device, and to the release wire, where the release wire extends through the second loop.

Abstract: An assembly for replacement of a native aortic heart valve includes a radially collapsible prosthetic heart valve and a delivery apparatus. The prosthetic heart valve includes an annular frame with attachment posts, wherein each of the posts has an axial post portion and a transverse post portion having a greater circumferential dimension than the axial post portion. The delivery apparatus includes an inner shaft with a valve connection portion for releasably coupling to the attachment posts and an outer shaft having a sheath for maintaining the prosthetic heart valve in a radially compressed state. Rotation of a control knob on a handle causes the sheath to retract for uncovering a portion of the prosthetic heart valve. Further rotation of the control knob allows the posts to decouple from the delivery apparatus such that the prosthetic heart valve self-expands to a fully expanded state.

Abstract: A constricting cord can be delivered to the vicinity of an annulus using an apparatus that includes a set of support arms, with a respective anchor launcher supported by each of the support arms. An inflatable first balloon is configured to push the support arms away from each other when the first balloon is inflated. An inflatable second balloon is mounted to a shaft and is configured for inflation when the second balloon is disposed distally beyond the first balloon. In some embodiments, the distal balloon is inflated while it is in a ventricle. In some embodiments, the distal balloon is inflated while it is in a pulmonary artery.