Abstract: A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.

Abstract: An implant (150) comprises a patch (210), a patch anchor (240), a downstream assembly (300) comprising a winch (320) coupled to a winch anchor (310), and a tether (160) tethering the winch to the patch. A delivery tool (400) has a distal portion that is transluminally advanceable to a heart while the implant is mounted on the delivery tool. The delivery tool has a shaft, a clasp (430), comprising an upstream support and a downstream support, the clasp configured to grasp a portion of a leaflet of a valve of the heart between the upstream support and the downstream support of the clasp, and a driver, configured to anchor the patch to the portion of the leaflet using the patch anchor while the portion of the leaflet remains grasped by the clasp. Other embodiments are also described.

Abstract: A system comprises an anchor (20) comprising an inner helical tissue-engaging element (24); an outer helical tissue-engaging element (22); and a head assembly (29). The head assembly comprises a first head (25), fixed to a proximal end of the inner tissue-engaging element, and a second head (26), fixed to a proximal end of the outer tissue-engaging element. The system further comprises a driver (28), reversibly interfacing with and engaging the first head and the second head, in order to anchor the anchor in the target tissue. Other applications are also described.

Abstract: A system includes an anchor, a delivery tool, and a data-processing system. The delivery tool is configured to deliver the anchor to the heart of the subject, and to drive the anchor into tissue of the heart. The data-processing system is adapted to, subsequently to the delivery tool delivering the anchor to the heart, receive, via the delivery tool, a first electrical signal from the anchor, at the tissue, the anchor serving as an electrode. The data-processing system is adapted to receive, via the delivery tool, a second electrical signal from a distal part of the delivery tool within the heart. The data-processing system is adapted to, responsively to both the first signal and the second signal, determine a location of the anchor within the heart, and provide an output indicative of the location. Other embodiments are also disclosed.

Abstract: A device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. One or more portions of device or implant can expand and contract. For example, one or more portions of the device or implant can narrow during delivery and expand on implantation on the native heart valve. Delivery systems are configured to narrow and expand the one or more portions of the device or implant.

Abstract: A prosthetic valve includes a tubular valve body, snares, and an upstream support. A native valve of a heart of a subject is disposed between an atrium and a ventricle of the heart, and has an annulus and leaflets. The prosthetic valve is advanced to the heart while in a compressed state. The prosthetic valve is positioned within the heart such that the snares are disposed upstream of the annulus and leaflets. The snares are expanded radially outwardly upstream of the leaflets. Subsequently, the prosthetic valve is moved in a downstream direction such that the snares become disposed downstream of the leaflets. While the snares remain downstream of the leaflets, the upstream support is expanded within the atrium, and the upstream support is placed against an upstream surface of the annulus. Other embodiments are also described.

Abstract: An implantable device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. The implantable device or implant can include a pair of paddles frame a coaptation element. The coaptation element defines a first area when viewed from above. The paddle frames define when viewed from above. A ratio of the second area to the first area is greater than or equal to 2 to 1.

Abstract: A method of repairing a mitral valve of a heart of a subject comprises positioning an elongate support of an implant at the heart such that the support is aligned with a coronary sinus of the heart. A first anchor of the implant is anchored to a first location on an anterior side of the valve, such that a first tether-segment of the implant spans across the valve between the first anchor and a first end of the support. A second anchor of the implant is anchored to a second location on the anterior side of the valve, such that a second tether-segment of the implant spans across the valve between the second anchor and a second end of the support. Other embodiments are also described.

Abstract: A prosthetic heart valve implant is provided including a frame shaped so as to define upstream and downstream openings at upstream and downstream ends of the frame, respectively, when the implant is in an expanded state for implantation at a heart native valve. A sheet is coupled to the frame. When the implant is in the expanded state, the frame is shaped so as to define the following longitudinal portions arranged along a central longitudinal axis of the prosthetic heart valve implant: a substantially cylindrical mid portion having a diameter greater than respective diameters of the upstream and the downstream ends of the frame; an upstream portion, extending upstream and radially inward from the mid portion; and a downstream portion, extending downstream and radially inward from the mid portion. Other embodiments are also described.

Abstract: An implant comprises a leaflet-augmentation patch, a patch anchor, and a cord. The patch comprises a flexible sheet, and a frame that supports the flexible sheet. The frame defines a spring configured to tension the cord. The cord couples the patch anchor to the patch in a manner in which anchoring the patch anchor to a first leaflet of a heart valve of a subject positions the patch to coapt with a second leaflet of the valve during ventricular systole. Other embodiments are also described.

Abstract: An implant comprises a helical member. A guide assembly is used to guide the implantation of the helical member along a tissue of a heart. The guide assembly has a distal part that is transluminally advanceable to the heart, and comprises a guide frame that is intracardially expandable toward an expanded state, a guide rail, and multiple fasteners, configured to hold the guide rail in a guide arrangement around at least part of the guide frame. A driver of the system is configured to, while the guide rail is in the guide arrangement, anchor the helical member along an intracardial surface of tissue adjacent the guide frame, guided by the guide rail. Other implementations are also described.

Abstract: An implantable device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. In some implementations, the implantable device or implant, or one or more portions thereof, can be configured to expand and/or contract. For example, the implantable device or implant can narrow during delivery and expand on implantation on the native heart valve.

Abstract: A rod (508) is transfemorally advanceable to the heart. An implant (460) comprises (i) a first frame (462), compressed around a first longitudinal site of a distal portion of the rod, (ii) a second frame (464), compressed around a third longitudinal site of the distal portion, (iii) a valve member (50), disposed within the second frame, and (iv) a flexible sheet (466), coupling the first frame to the second frame, and disposed around a second longitudinal site of the distal portion, the second longitudinal site being between the first longitudinal site and the third longitudinal site. An extracorporeal controller (569) is coupled to a proximal portion of the rod, and is operably coupled to the distal portion of the rod. Operating the controller bends the distal portion of the rod causing articulation between the frames. Other embodiments are also described.

Abstract: A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.

Abstract: A prosthetic valve includes a tubular valve body, snares, and an upstream support. A native valve of a heart of a subject is disposed between an atrium and a ventricle of the heart, and has an annulus and leaflets. The prosthetic valve is advanced to the heart while in a compressed state. The prosthetic valve is positioned within the heart such that the snares are disposed upstream of the annulus and leaflets. The snares are expanded radially outwardly upstream of the leaflets. Subsequently, the prosthetic valve is moved in a downstream direction such that the snares become disposed downstream of the leaflets. While the snares remain downstream of the leaflets, the upstream support is expanded within the atrium, and the upstream support is placed against an upstream surface of the annulus. Other embodiments are also described.

Abstract: A rod (508) is transfemorally advanceable to the heart. An implant (460) comprises (i) a first frame (462), compressed around a first longitudinal site of a distal portion of the rod, (ii) a second frame (464), compressed around a third longitudinal site of the distal portion, (iii) a valve member (50), disposed within the second frame, and (iv) a flexible sheet (466), coupling the first frame to the second frame, and disposed around a second longitudinal site of the distal portion, the second longitudinal site being between the first longitudinal site and the third longitudinal site. An extracorporeal controller (569) is coupled to a proximal portion of the rod, and is operably coupled to the distal portion of the rod. Operating the controller bends the distal portion of the rod causing articulation between the frames. Other embodiments are also described.

Abstract: A prosthetic valve is advanced to a heart of a subject while the prosthetic valve is in a compressed state thereof, the prosthetic valve including a plurality of snares coupled to a tubular valve body. The prosthetic valve is positioned within the heart such that the plurality of snares is disposed upstream of the leaflets, and the plurality of snares is expanded upstream of the leaflets. Subsequently the prosthetic valve is moved in a downstream direction such that the plurality of snares is disposed downstream of the leaflets. Subsequently, the prosthetic valve is secured at the native valve while the plurality of snares remains disposed downstream of the leaflets.

Abstract: A prosthetic valve is advanced to a heart of a subject while the prosthetic valve is in a compressed state thereof, the prosthetic valve including a plurality of snares coupled to a tubular valve body. The prosthetic valve is positioned within the heart such that the plurality of snares is disposed upstream of the leaflets, and the plurality of snares is expanded upstream of the leaflets. Subsequently the prosthetic valve is moved in a downstream direction such that the plurality of snares is disposed downstream of the leaflets. Subsequently, the prosthetic valve is secured at the native valve while the plurality of snares remains disposed downstream of the leaflets.

Abstract: A rod (508) is transfemorally advanceable to the heart. An implant (460) comprises (i) a first frame (462), compressed around a first longitudinal site of a distal portion of the rod, (ii) a second frame (464), compressed around a third longitudinal site of the distal portion, (iii) a valve member (50), disposed within the second frame, and (iv) a flexible sheet (466), coupling the first frame to the second frame, and disposed around a second longitudinal site of the distal portion, the second longitudinal site being between the first longitudinal site and the third longitudinal site. An extracorporeal controller (569) is coupled to a proximal portion of the rod, and is operably coupled to the distal portion of the rod. Operating the controller bends the distal portion of the rod causing articulation between the frames. Other embodiments are also described.