Abstract: A method of treating a tricuspid valve that defines an annulus between a right atrium and a right ventricle of the heart is described. A first anchor and a second anchor are transluminally advanced to the heart. The first anchor is anchored inside a coronary sinus of the heart. The second anchor is anchored, from the right atrium, at a site that is across the annulus from the coronary sinus by driving a distal portion of the second anchor into the annulus at the site. Subsequently, a distance between the first and second anchors is reduced by applying tension to a tensioning member coupled to the first and second anchors. The tension is maintained by locking a lock member to the tensioning member. Other embodiments are also described.

Abstract: A first anchor is anchored inside a coronary sinus of a heart of a subject. A second anchor can be driven into a tricuspid annulus of the heart. A distal portion of the second anchor can be disposed adjacent and parallel to a center portion of the second anchor. The second anchor can be seated against a surface of the annulus, for example, such that (i) the distal portion is disposed perpendicular to the center portion, (ii) the center portion extends through the annulus, and (iii) a proximal portion of the second anchor is disposed in the atrium. A distance between the first and second anchors can be reduced by applying tension to a tensioning member coupled to the first anchor and the proximal portion of the second anchor. Other embodiments are also described.

Abstract: A first end of a wire is transluminally penetrated through tissue at a first cardiovascular site of a subject. A capture device is transluminally advanced into the subject, and is used to capture the first end of the wire and pull the first end of the wire away from the first cardiovascular site. From the first end of the wire, a first anchor is tracked along the wire, and is then anchored to the tissue at the first cardiovascular site. A second anchor is anchored to tissue at a second cardiovascular site. Subsequently, the first and second cardiovascular sites are drawn together by applying tension between the first and second anchors. Other embodiments are also described.

Abstract: A first end of a wire is transluminally advanced to a location adjacent an atrium of a heart of a subject, while a second end of the wire remains disposed outside of the subject. From the location, the first end of the wire is penetrated through tissue into the atrium. A capture device is transluminally advanced into the atrium. Using the capture device, the first end of the wire is captured and pulled out of the subject. From the first end of the wire, a first anchor is tracked along the wire into the atrium, and is anchored to an annulus of a valve of the heart. A second anchor is advanced into the atrium, and is anchored to the annulus. Subsequently, the annulus is reshaped by applying tension between the first and second anchors.

Abstract: A system is transluminally advanced into a subject. A first portion of the system is positioned adjacent a cardiovascular tissue of the subject, the system including wires disposed at the first portion. The first portion is stabilized at the cardiovascular tissue by positioning a distal portion of the system against a cardiovascular wall of the subject. While the distal portion of the system remains against the cardiovascular wall, the wires are induced to bow laterally such that the wires press against the cardiovascular tissue. While the wires remain pressed against the cardiovascular tissue, the shape of the wires is radiographically imaged. While (i) the first portion remains stabilized, and (ii) the wires remain pressed against the cardiovascular tissue, at least a portion of the system is transluminally implanted at the cardiovascular tissue, facilitated by the imaging. Other embodiments are also described.

Abstract: A system is transluminally advanced into the heart of a subject. A first portion of the system is positioned through a native valve of the heart, the system including wires disposed at the first portion. The first portion is stabilized at the native valve by positioning a distal portion of the system within a blood vessel of the subject. While the distal portion of the system remains within the blood vessel, the wires are induced to bow laterally such that the wires press against the native valve. While the wires remain pressed against the native valve, the shape of the wires is radiographically imaged. An anchor is transluminally anchored to tissue of the native valve, facilitated by the imaging. Other embodiments are also described.

Abstract: The present teachings provide systems, devices, and methods for treating the heart and reducing valve regurgitation. A delivery catheter is used to advance a balloon to a treatment site outside the heart. The balloon includes a flexible outer layer encasing a primary cavity and a secondary cavity outside of the primary cavity. The secondary cavity contains a tissue-binding adhesive. While the balloon is at the treatment site, an injection medium is introduced into the primary cavity in a manner that inflates the balloon from a collapsed delivery profile into an inflated deployment profile, and squeezes the tissue-binding adhesive out of the secondary cavity. Other embodiments are also described.

Abstract: Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.

Abstract: The present teachings provide systems, devices, and methods for reshaping the heart and reducing valve regurgitation. A device can be positioned proximate the heart and have a delivery profile and an inflated profile. The device can have a primary cavity and a secondary cavity, and an adhesive inside the secondary cavity. An injectable medium can be injected to the primary cavity of the device. As the primary cavity is filled, the adhesive is forced out of the secondary cavity to adhere the device. The inflated device can exert pressure on the heart, change the shape of a valve annulus, and allow a better coaptation of the valve leaflets.

Abstract: The present teachings provide methods for resizing, reducing, and/or closing an atrial appendage. A delivery catheter is percutaneously advanced to the atrial appendage. At least two tissue anchors are implanted in tissue of the heart. Both tissue anchors are pulled together so that the atrial appendage is resized, reduced, and/or closed. This closure method and system could be used alone in closing the atrial appendage. This closure method and system could also be used in addition to other treatment mechanisms.

Abstract: An elongate member has a longitudinal axis, and has an elongated configuration in which the elongate member defines (i) a first portion that defines a first-portion folding line, substantially orthogonal to the longitudinal axis, (ii) a second portion that defines a second-portion folding line, substantially parallel to the first-portion folding line, and (iii) an oblique folding line, longitudinally between the first portion and the second portion. The oblique folding line is nonparallel and nonorthogonal to the longitudinal axis. A tensioning member weaves longitudinally along the elongate member such that applying tension to the tensioning member transitions the elongate member toward a folded configuration by folding (i) the first and second portions about their respective folding lines, and (ii) the elongate member about the oblique folding line in a manner that positions the first-portion folding line nonparallel to the second-portion folding line.

Abstract: A system is transluminally advanced into the heart of a subject. A first portion of the system is positioned through a native valve of the heart, the system including wires disposed at the first portion. The first portion is stabilized at the native valve by positioning a distal portion of the system within a blood vessel of the subject. While the distal portion of the system remains within the blood vessel, the wires are induced to bow laterally such that the wires press against the native valve. While the wires remain pressed against the native valve, the shape of the wires is radiographically imaged. An anchor is transluminally anchored to tissue of the native valve, facilitated by the imaging. Other embodiments are also described.

Abstract: A first end of a wire is transluminally advanced to a location adjacent an atrium of a heart of a subject, while a second end of the wire remains disposed outside of the subject. From the location, the first end of the wire is penetrated through tissue into the atrium. A capture device is transluminally advanced into the atrium. Using the capture device, the first end of the wire is captured and pulled out of the subject. From the first end of the wire, a first anchor is tracked along the wire into the atrium, and is anchored to an annulus of a valve of the heart. A second anchor is advanced into the atrium, and is anchored to the annulus. Subsequently, the annulus is reshaped by applying tension between the first and second anchors.

Abstract: The present teachings provide devices and methods of locating a mitral valve commissure, and implanting tissue anchors at or near the mitral valve commissure. Specifically, one aspect of the present teachings provides devices and methods for locating a mitral valve commissure percutaneously and allowing a guide wire to be placed across a mitral annulus at the mitral valve commissure. Another aspect of the present teachings provides methods for deploying a tissue anchor across a mitral annulus at a mitral valve commissure, including near the P1 or P3 regions of the posterior mitral annulus. Another aspect of the present teachings further provides methods of plicating a mitral annulus between two or more tissue anchors.

Abstract: A first anchor is anchored inside a coronary sinus of a heart of a subject. A second anchor can be driven into a tricuspid annulus of the heart. A distal portion of the second anchor can be disposed adjacent and parallel to a center portion of the second anchor. The second anchor can be seated against a surface of the annulus, for example, such that (i) the distal portion is disposed perpendicular to the center portion, (ii) the center portion extends through the annulus, and (iii) a proximal portion of the second anchor is disposed in the atrium. A distance between the first and second anchors can be reduced by applying tension to a tensioning member coupled to the first anchor and the proximal portion of the second anchor. Other embodiments are also described.

Abstract: The present teachings provide systems, devices, and methods for reshaping the heart and reducing valve regurgitation. A device can be positioned proximate the heart and have a delivery profile and an inflated profile. The device can have a primary cavity and a secondary cavity, and an adhesive inside the secondary cavity. An injectable medium can be injected to the primary cavity of the device. As the primary cavity is filled, the adhesive is forced out of the secondary cavity to adhere the device. The inflated device can exert pressure on the heart, change the shape of a valve annulus, and allow a better coaptation of the valve leaflets.

Abstract: The present teachings provide methods for resizing, reducing, and/or closing an atrial appendage. A delivery catheter is percutaneously advanced to the atrial appendage. At least two tissue anchors are implanted in tissue of the heart. Both tissue anchors are pulled together so that the the atrial appendage is resized, reduced, and/or closed. This closure method and system could be used alone in closing the atrial appendage. This closure method and system could also be used in addition to other treatment mechanisms.

Abstract: The present teachings provide methods for resizing, reducing, and closing left atrial appendage. Specifically, a percutaneous trans-septal access is first established from outside the body to a patient's LAA. At least two tissue anchors are then implanted inside the LAA chamber and along the tissue wall. At least one anchor is implanted near the opening of the LAA camber. Both tissue anchors are pulled together so that the wall of the LAA chamber collapse. The LAA chamber is therefore resized, reduced, and/or closed off completely. This closure method and system could be used alone in closing LAA chamber. This closure method and system could also be used in addition to other treatment mechanisms, such as filling the LAA chamber with space-filling material, then closing off its opening.

Abstract: The present teachings provide devices and methods of locating a mitral valve commissure, and implanting tissue anchors at or near the mitral valve commissure. Specifically, one aspect of the present teachings provides devices and methods for locating a mitral valve commissure percutaneously and allowing a guide wire to be placed across a mitral annulus at the mitral valve commissure. Another aspect of the present teachings provides methods for deploying a tissue anchor across a mitral annulus at a mitral valve commissure, including near the P1 or P3 regions of the posterior mitral annulus. Another aspect of the present teachings further provides methods of plicating a mitral annulus between two or more tissue anchors.

Abstract: Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.