Abstract: An articulated prosthesis, left in the patient's heart for repairing a tricuspid or mitral valve, is disclosed. The prosthesis is designed to grip simultaneously all the three leaflets of the tricuspid valve, or two of the mitral valves, so as to make them lay distended fully in the valve plane and assume a final configuration as in the common surgical procedure, with the leaflets pulled towards the center of the valve.

Abstract: A method is provided that includes implanting a first tissue-engaging element in a first portion of tissue in a vicinity of a heart valve. A second tissue-engaging element, which is connected to a third tissue-engaging element by a longitudinal sub-member, is implanted in a second portion of tissue of an annulus, and the third tissue-engaging element is implanted in a third portion of tissue of the annulus. A fourth tissue-engaging element is implanted in a portion of a blood vessel that is in contact with an atrium. While the longitudinal sub-member engages the longitudinal member at a junction therebetween, at least a first leaflet of the heart valve is drawn toward at least a second leaflet of the heart valve by adjusting a distance between the portion of the blood vessel and the first portion of tissue in the vicinity of the heart valve. Other embodiments are also described.

Abstract: An articulated prosthesis, left in the patient's heart for repairing a tricuspid or mitral valve, is conceived so as to grip simultaneously all the three leaflets of the tricuspid valve, or the two of the mitral valve, so as to make them lay distended fully in the valve plane and assume a final configuration as in the common surgical procedure. It is also disclosed a related catching device and a device for repairing a tricuspid or mitral valve.

Abstract: A suture-securing device includes a first tubular element, shaped to define a first lumen therethrough, and having first and second ends; and a second tubular element, shaped to define a second lumen therethrough, and having first and second ends. The suture-securing device is configured to have (a) an unlocked configuration in which the first end of the second tubular element is disposed closer to the first end of first tubular element than is the second end of the second tubular element, and the sutures are disposable within and slidable through the first and second lumens, and (b) a locking configuration in which the second end of the second tubular element is disposed closer to the first end of first tubular element than is the first end of the second tubular element, and the sutures are inhibited from sliding through the first and second lumens. Other embodiments are also described.

Abstract: An articulated prosthesis, left in the patient's heart for repairing a tricuspid or mitral valve, is conceived so as to grip simultaneously all the three leaflets of the tricuspid valve, or the two of the mitral valve, so as to make them lay distended fully in the valve plane and assume a final configuration as in the common surgical procedure. It is also disclosed a related catching device and a device for repairing a tricuspid or mitral valve.

Abstract: A method is provided, including implanting at least a first tissue-engaging element (60a) in a first portion of tissue in a vicinity of a heart valve (4) of a patient, implanting at least a second tissue-engaging element (60b) in a portion of a blood vessel (8, 10) that is in contact with an atrium (6) of a heart (2) of the patient, and drawing at least a first leaflet of the valve (4) toward at least a second leaflet of the valve (4) by adjusting a distance between the portion of the blood vessel (8, 10) and the first portion of tissue in the vicinity of the heart valve (4) of the patient. Other applications are also described.

Abstract: A suture-securing device includes a first tubular element, shaped to define a first lumen therethrough, and having first and second ends; and a second tubular element, shaped to define a second lumen therethrough, and having first and second ends. The suture-securing device is configured to have (a) an unlocked configuration in which the first end of the second tubular element is disposed closer to the first end of first tubular element than is the second end of the second tubular element, and the sutures are disposable within and slidable through the first and second lumens, and (b) a locking configuration in which the second end of the second tubular element is disposed closer to the first end of first tubular element than is the first end of the second tubular element, and the sutures are inhibited from sliding through the first and second lumens. Other embodiments are also described.

Abstract: Prosthetic annuloplasty ring(s) configured to attach to and remodel a valve annulus. Each ring can comprise a generally oval shaped inner body made of a semi-rigid material. The inner body can be surrounded by an outer suture-permeable sheath that permits the ring body to be attached to the valve annulus. The inner body can include a posterior section contiguous with an anterior section together forming a continuous periphery oriented about a flow axis. In plan view as seen along the flow axis, the ring can have a major axis perpendicular to a minor axis, wherein a maximum dimension lies along the major axis and a minimum dimension lies along the minor axis. The rings can be a set of rings of increasing ring sizes, where a ratio of the minimum dimension to the maximum dimension changes for at least some of the rings of different ring sizes.

Abstract: Apparatus is provided that includes a casing, shaped to define a cavity, and one or more openings in the casing, in which openings one or more sutures are disposable; and a core, disposed in the cavity, and shaped to define a lumen in which the sutures are disposable. The apparatus has an unlocked configuration in which the sutures are disposable within and slidable through the openings and the lumen, and a locking configuration in which the sutures are inhibited from sliding through the openings and the lumen. The apparatus is movable from the unlocked configuration to the locking configuration, and is configured such that, when the sutures are disposed within the openings and the lumen, and the apparatus moves from the unlocked configuration to the locking configuration, the apparatus cuts the sutures at a cutting site, and becomes coupled to the sutures at a coupling site.

Abstract: Methods of remodeling an abnormal mitral valve with an annuloplasty ring having a reduced anterior-to-posterior dimension to restore coaptation between the mitral leaflets in mitral valve insufficiency (IMVI). The ring has a generally oval shaped body with a major axis perpendicular to a minor axis. An anterior section lies between anteriolateral and posteriomedial trigones, while a posterior section defines the remaining ring body and is divided into P1, P2, and P3 segments. The anterior-to-posterior dimension of the ring body is reduced from conventional rings; such as by providing, in atrial plan view, a pulled-in P3 segment. The ring body may have a downwardly deflected portion in the posterior section. The downwardly deflected portion may have an apex which is the lowest elevation of the ring body and may be offset with respect to the center of the downwardly deflected portion toward the P3 segment.

Abstract: Apparatus is provided that includes a casing, shaped to define a cavity, and one or more openings in the casing, in which openings one or more sutures are disposable; and a core, disposed in the cavity, and shaped to define a lumen in which the sutures are disposable. The apparatus has an unlocked configuration in which the sutures are disposable within and slidable through the openings and the lumen, and a locking configuration in which the sutures are inhibited from sliding through the openings and the lumen. The apparatus is movable from the unlocked configuration to the locking configuration, and is configured such that, when the sutures are disposed within the openings and the lumen, and the apparatus moves from the unlocked configuration to the locking configuration, the apparatus cuts the sutures at a cutting site, and becomes coupled to the sutures at a coupling site.

Abstract: Methods of remodeling an abnormal mitral valve with an annuloplasty ring having a reduced anterior-to-posterior dimension to restore coaptation between the mitral leaflets in mitral valve insufficiency (IMVI). The ring has a generally oval shaped body with a major axis perpendicular to a minor axis. An anterior section lies between anteriolateral and posteriomedial trigones, while a posterior section defines the remaining ring body and is divided into P1, P2, and P3 segments. The anterior-to-posterior dimension of the ring body is reduced from conventional rings; such as by providing, in atrial plan view, a pulled-in P3 segment. The ring body may have a downwardly deflected portion in the posterior section. The downwardly deflected portion may have an apex which is the lowest elevation of the ring body and may be offset with respect to the center of the downwardly deflected portion toward the P3 segment.

Abstract: Apparatus is provided including a radially-expandable percutaneous implant shaped so as to define a tension-distributing element. A flexible longitudinal member is coupled at a first portion thereof to at least a portion of the percutaneous implant via the tension-distributing element. The tension-distributing element is configured to distribute tension applied by the flexible longitudinal member along a longitudinal length of the percutaneous implant.

Abstract: Methods of remodeling an abnormal mitral valve with an annuloplasty ring having a reduced anterior-to-posterior dimension to restore coaptation between the mitral leaflets in mitral valve insufficiency (IMVI). The ring has a generally oval shaped body with a major axis perpendicular to a minor axis. An anterior section lies between anteriolateral and posteriomedial trigones, while a posterior section defines the remaining ring body and is divided into P1, P2, and P3 segments. The anterior-to-posterior dimension of the ring body is reduced from conventional rings; such as by providing, in atrial plan view, a pulled-in P3 segment. The ring body may have a downwardly deflected portion in the posterior section. The downwardly deflected portion may have an apex which is the lowest elevation of the ring body and may be offset with respect to the center of the downwardly deflected portion toward the P3 segment.

Abstract: Techniques are described for use with one or more sutures. For some applications, techniques are described for fixedly-coupling two or more sutures to each other. For some applications, such techniques are used for treating a heart valve of a subject. Techniques are also described for treating a heart valve of a subject by coupling leaflets of the heart valve to a support using tissue-piercing elements. Other embodiments are also described.

Abstract: Techniques are described for use with one or more sutures. For some applications, techniques are described for fixedly-coupling two or more sutures to each other. For some applications, such techniques are used for treating a heart valve of a subject. Techniques are also described for treating a heart valve of a subject by coupling leaflets of the heart valve to a support using tissue-piercing elements. Other embodiments are also described.

Abstract: Apparatus is provided, including a radially-expandable percutaneous implant, a tissue anchor, and a connecting element shaped so as to provide an annular loop surrounding a proximal portion of the tissue anchor in a manner which enables rotation of the anchor about a central longitudinal axis thereof when surrounded by the annular loop. The apparatus also includes a flexible longitudinal member coupled at a first portion thereof to at least a portion of the percutaneous implant and at a second portion to the connecting element. The annular loop of the connecting element facilitates rotation of the tissue anchor about the central longitudinal axis such that the anchor can rotate about the central longitudinal axis with respect to the annular loop, the flexible longitudinal member, and the percutaneous implant. Other applications are also described.

Abstract: Techniques are described for use with one or more sutures. For some applications, techniques are described for fixedly-coupling two or more sutures to each other. For some applications, such techniques are used for treating a heart valve of a subject. Techniques are also described for treating a heart valve of a subject by coupling leaflets of the heart valve to a support using tissue-piercing elements. Other embodiments are also described.

Abstract: The present invention refers to an annular prosthesis for mitral valve. In one of its embodiments the annular prosthesis for mitral valve is made up of a posterior half-ring and an anterior half-ring coupled to each other on a first transverse plane which defines a maximum width section of the prosthesis, characterized in that the ratio between the distance between said anterior half-ring and said posterior half-ring, as measured along a second plane, perpendicular to said first plane and equidistant to said couplings, and said maximum width of the prosthesis is lower than ¾.

Abstract: A prosthetic tricuspid remodeling annuloplasty ring having two free ends and at least one inward bow to help reduce chordal tethering. The ring may have segments corresponding to the anterior, posterior and septal leaflets, with inward bows located adjacent one, two or all leaflets. Convex corners separate the concave inward bows, with inflection points therebetween. The ring has a semi-rigid inner body covered by fabric or a suture interface such as silicone and fabric.