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 enlarged cardiac valve annulus can be reduced in diameter using a cord that is affixed to the annulus by a set of anchors. A knot or fixed loop is disposed at a first end of the cord, and the body of the cord passes through the knot or fixed loop so as to form (a) a loop portion positioned distally beyond the knot or fixed loop and (b) a second portion that runs between the knot or fixed loop and the second end. The body of the cord can slide with respect to the knot or fixed loop. After the anchors are implanted and a bond between the anchors and the annulus is sufficiently strong, pulling the second portion in a proximal direction while holding the knot or fixed loop in place will reduce the circumference of the annulus.

Abstract: A cord that has been previously affixed around an annulus can be fastened using a sliding member that locks into a housing. Before those two parts are locked together, the cord is free to slide through a channel in the sliding member, and a shear pin prevents the sliding member from moving. After those two parts are locked together, portions of the cord are squeezed between the upper surface of the sliding member and one wall of the housing, and other portions of the cord are squeezed between the lower surface of the sliding member and another wall of the housing, so that the cord can no longer slide. After locking, a sliding cutting element can be actuated to cut off portions of the cord that are proximal with respect to the two locked parts.

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.