Abstract: Dislodgment of a constricting cord from an annulus can be prevented by delivering the distal loop portion of the constricting cord to the annulus using a percutaneous delivery tool, and launching anchors into the annulus so as to affix the distal loop portion of the constricting cord to the annulus. The percutaneous delivery tool is withdrawn in a proximal direction after the anchors have been launched. A pushing member is pressed in a distal direction so that the pushing member holds a portion of the constricting cord against the annulus with enough pressure to prevent dislodgment of any of the anchors during the withdrawal of the percutaneous delivery tool.

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.

Abstract: A cardiac valve annulus may be constricted by using an apparatus to deliver a cord to the annulus, affixing the cord, and subsequently tightening that cord. In some embodiments, this apparatus includes a housing, a spool, and an elongated core with lumens that run through the core. The lumens are dimensioned to slidably accommodate portions of the cord. The cord, the lumens, and the spool are configured so that after a distal loop portion of the cord is anchored to the annulus, movement of the housing in a proximal direction will (a) cause the core to progressively move in a proximal direction with respect to portions of the cord and (b) cause extension sections of the cord to progressively unwind from the spool and be progressively drawn into the lumens.

Abstract: An annulus ring or a constricting cord may be delivered to the vicinity of a cardiac annulus using a set of anchor launchers, with each of the anchor launchers being supported by a respective support arm. An inflatable balloon is disposed between the support arms, and the balloon is configured so that when the balloon is inflated, the balloon will push the support arms away from each other. At least one retainer cord is connected to the support arms and is arranged with respect to the support arms to encompass the balloon and prevent the balloon from slipping out between the support arms.

Abstract: Tissue ingrowth on the distal loop portion of a constricting cord can dramatically improve the bond between the constricting cord and a cardiac valve annulus. But tissue ingrowth on the proximal portions of the constricting cord can interfere with the constricting action of the cord. This problem can be addressed by covering the proximal portions of the constricting cord with a material that resists tissue ingrowth, and waiting for tissue ingrowth to strengthen the bond between the distal loop portion of the constricting cord and the annulus. The reduced ingrowth on the proximal portions of the constricting cord make it easier to constrict the annulus when the constricting operation is eventually performed.

Abstract: A cardiac valve annulus may be constricted by using an apparatus to deliver a cord to the annulus, affixing the cord, and subsequently tightening that cord. In some embodiments, this apparatus includes an elongated core with a main channel, a set of first channels, and at least one second channel, all of which run through the core. The first channels accommodate pull wires for triggering the anchor launchers, and the second channels accommodate portions of the cord. Support arms extend distally beyond the core, and anchor launchers are mounted to each of these support arms. The support arms hold the distal ends of the anchor launchers at positions distributed about the annulus. The anchors are launched to affix the cord, and the cord is tightened in a subsequent procedure.

Abstract: A method of treating a mitral valve without open-heart surgery is disclosed. An expandable prosthesis comprises an anchoring portion and an occluding member coupled to the anchoring portion. The prosthesis is loaded into a distal end of a delivery catheter and advanced through a femoral vein and through a pre-made puncture in an atrial septum. The occluding member is then positioned in the mitral valve and the anchoring portion is positioned in the left atrium for maintaining the occluding member between the leaflets of the mitral valve. After deployment, the occluding member prevents blood from flowing from the left ventricle to the left atrium during systole.

Abstract: The ventricle of a heart can be reshaped by passing a plurality of catheters from inside the ventricle to outside the ventricle through holes in the ventricle wall. Fluid-tight bags are then delivered through the catheters and expanded outside the ventricle to a diameter that is larger than the holes. A fluid substance is introduced into the bags, and the fluid substance is configured to solidify into solid pads that are also larger than the holes. The solid pads are then pulled towards each other and locked in position in order to reshape the ventricle.

Abstract: The invention is a method for reducing regurgitation through a mitral valve. The device and method is directed to an anchor portion for engagement with the heart wall and an expandable valve portion configured for deployment between the mitral valve leaflets. The valve portion is expandable for preventing regurgitation through the mitral valve while allowing blood to circulate through the heart. The expandable valve portion may include apertures for reducing the stagnation of blood. In a preferred configuration, the device is preferably configured to be delivered in two-stages wherein an anchor portion is first delivered and the valve structure is then coupled to the anchor portion. In yet another embodiment, the present invention provides a method of forming an anchor portion wherein a disposable jig is used to mold the anchor portion into a three-dimensional shape for conforming to a heart chamber.

Abstract: A prosthetic device for treating a mitral valve includes a prosthetic insert member insertable between leaflets of mitral valve. The insert member has an elongated cross-sectional profile for conforming to gap between leaflets of a mitral valve. The device also includes an anchoring member for attachment to heart tissue for maintaining the insert member in the mitral valve. The insert member includes a valve that permits one-way blood flow therethrough. An anchoring member secures the prosthetic insert member to a heart wall.

Abstract: A method of using a device to improve the function of a heart valve is disclosed. In one preferred embodiment, the method includes positioning a prosthetic insert member between leaflets of mitral valve. The insert member has an elongated cross-sectional profile for conforming to gap between leaflets of a mitral valve. The device also includes an anchoring member for attachment to heart tissue for maintaining the insert member in the mitral valve. The insert member is used to plug the gap between the leaflets of the mitral valve and thereby reduce undesirable regurgitation while allowing the leaflets to function in a substantially normal manner. An anchoring member secures the prosthetic insert member to a heart wall. The anchoring member preferably includes a plurality of tissue penetrating hooks or prongs.

Abstract: An apparatus for cinching an anatomic passage (e.g., the annulus of the mitral valve or another cardiac valve) includes a cinching cord, slotted anchors, and corresponding sliding members disposed in the slots of the anchors. The sliding members are held captive within the slots by a protrusion on one side of the slot and by the presence of the cinching cord in apertures of the sliding members on the other side of the slot, because the cinching cord passes through the aperture in each of the sliding members. In some embodiments, at least one sleeve of material that accepts tissue ingrowth is disposed over the cinching cord. A closed loop of cord may also be used in place of the cinching cord in alternative embodiments, so that subsequent to implantation, the closed loop of cord prevents the anatomic annulus from expanding.

Abstract: Embodiments of the present disclosure provide a prosthetic heart valve and a heart valve delivery apparatus for delivery of the prosthetic heart valve to a native valve site via the human vasculature. The delivery apparatus is particularly suited for advancing a prosthetic valve through the aorta (i.e., in a retrograde approach) for replacing a diseased native aortic valve. In one embodiment, a self-expanding valve comprises an expandable stent that is shaped to maintain the valve in the aortic annulus against axial without anchors or retaining devices that engage the surrounding tissue. A delivery apparatus for delivering s self-expanding prosthetic valve can be configured to allow controlled and precise deployment of the valve from a valve sheath so as to minimize or prevent jumping of the valve from the valve sheath.

Abstract: A method for delivering a self-expanding prosthetic heart valve comprises positioning the prosthetic heart valve in an annulus of a native heart valve while mounted in a radially compressed state in a delivery cylinder, the delivery cylinder coupled to a distal end portion of the torque shaft, and rotating a torque shaft coupled to the delivery cylinder. Rotating the torque shaft retracts the delivery cylinder, thereby exposing the prosthetic heart valve, allowing the prosthetic heart valve to self-expand in the native valve annulus. In some embodiments, the torque shaft is rotated by a motor disposed in a handle at a proximal end of the delivery device.

Abstract: The diameter of an annulus in a patient (e.g., the mitral valve annulus) can be reduced using a tissue engaging member that is installed on the annulus and an actuator that is implanted into the patient's body. The tissue engaging member has anchors used to implant the tissue engaging member into the annulus, and a cinching loop runs through the tissue engaging member. The cinching loop terminates onto cinching wires. Preferably, tissue healing is used to enhance the bond between the tissue engaging member and the annulus. The actuator, which can be actuated from outside the patient's body, pulls the cinching wires in a proximal direction while holding the distal end of the cinching wires in close proximity to each other, so as to cause a reduction in the diameter of the cinching loop. This will cause a corresponding reduction in the diameter of the annulus.

Abstract: Apparatuses and methods are disclosed for performing a procedure on a heart valve in which a loop of material (160) is configured to contact at least a portion of the annulus or the leaflets of a valve. A plurality of anchors (16) are distributed about the loop and configured for implantation into the annulus or the leaflets in a forward direction. The anchors are configured to resist extraction in a backwards direction. A plurality of linking members (150) are affixed to the loop of material and at least a portion of each linking member passes through a slot (17) in a respective anchor so that the linking members can slide with respect to the slots. The anchors are then implanted into the annulus or the leaflets. The loop can then be used to retain a replacement valve or to cinch the annulus. A number of particularly advantageous anchor configurations are also disclosed.

Abstract: A method of using a device to improve the function of a heart valve is disclosed. In one preferred embodiment, the method includes positioning a prosthetic insert member between leaflets of mitral valve. The insert member has an elongated cross-sectional profile for conforming to gap between leaflets of a mitral valve. The device also includes an anchoring member for attachment to heart tissue for maintaining the insert member in the mitral valve. The insert member is used to plug the gap between the leaflets of the mitral valve and thereby reduce undesirable regurgitation while allowing the leaflets to function in a substantially normal manner. An anchoring member secures the prosthetic insert member to a heart wall. The anchoring member preferably includes a plurality of tissue penetrating hooks or prongs.

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: A method of treating a mitral valve without open-heart surgery is disclosed. An expandable prosthesis comprises an anchoring portion and an occluding member coupled to the anchoring portion. The prosthesis is loaded into a distal end of a delivery catheter and advanced through a femoral vein and through a pre-made puncture in an atrial septum. The occluding member is then positioned in the mitral valve and the anchoring portion is positioned in the left atrium for maintaining the occluding member between the leaflets of the mitral valve. After deployment, the occluding member prevents blood from flowing from the left ventricle to the left atrium during systole.

Abstract: A method of using a device to improve the function of a heart valve is disclosed. In one preferred embodiment, the method includes positioning a prosthetic insert member between leaflets of mitral valve. The insert member has an elongated cross-sectional profile for conforming to gap between leaflets of a mitral valve. The device also includes an anchoring member for attachment to heart tissue for maintaining the insert member in the mitral valve. The insert member is used to plug the gap between the leaflets of the mitral valve and thereby reduce undesirable regurgitation while allowing the leaflets to function in a substantially normal manner. An anchoring member secures the prosthetic insert member to a heart wall. The anchoring member preferably includes a plurality of tissue penetrating hooks or prongs.