Abstract: An apparatus can include: (1) a steerable tube, having a proximal section, a distal section, and a central longitudinal axis, the tube defining a primary lumen and two secondary lumens; (2) two wires, each extending from the distal section proximally through a respective secondary lumen; (3) a handle, coupled to the proximal section, and including a steering knob that is coupled to the wires such that rotation of the knob adjusts a degree of tension in the wires; (4) a pull ring coupled to the distal section of the tube such that the pull ring circumscribes the longitudinal axis at the distal section of the tube, and defining two recesses, a distal end portion of each wire being disposed in a respective one of the recesses; and (5) at least one cap, bridging the recesses and the distal end portion of the wires. 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: An annuloplasty implant is provided for treating a native atrioventricular valve of a patient, the annuloplasty implant including a plurality of tissue anchors, which are configured to anchor the annuloplasty implant around at least a portion of a valve annulus of the native atrioventricular valve. The annuloplasty further includes a contracting assembly, which includes an elongate contracting member; and a contracting mechanism, which is coupled to the elongate contracting member, and which is configured, upon actuation thereof, to apply a longitudinal contracting force to the elongate contracting member that longitudinally contracts at least a portion of the annuloplasty implant, thereby circumferentially tightening the valve annulus. The annuloplasty further includes a force-distributing element, which includes a longitudinally-non-compressible tightly-coiled element, and which is configured to distribute the longitudinal contracting force over at least two of the tissue anchors.

Abstract: An implant structure includes a contracting mechanism, including a rotatable structure for contracting the implant structure, and a locking mechanism. A rotation tool is configured to engage and rotate the rotatable structure. A longitudinal guide member is removably coupled to the contracting mechanism, configured to guide the rotation tool to the rotatable structure, and includes a distal force applicator. The rotation tool is axially moveable with respect to the guide member. The contracting mechanism is arranged such that the locking mechanism is (a) unlocked when the guide member is coupled to the contracting mechanism in a first state, thereby allowing the rotatable structure to rotate, and (b) locked when (i) the guide member is coupled to the contracting mechanism in a second state, thereby restricting the rotation of the rotatable structure, and (ii) the guide member is not coupled to the contracting mechanism, thereby restricting the rotation of the rotatable structure.

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: An apparatus is provided for connecting a portable medical device, such as an automatic injector, and a server. The apparatus includes a communication unit, a recognition unit for recognizing identification information on the portable medical device, and a pairing unit connected to the recognition unit to pair the apparatus with the portable medical device when recognized, thereby opening a first channel of communication with the medical device. The communication unit is configured to open up a second channel of communication with a server remotely over a network, and form a communication route between the portable medical device and the server.

Abstract: A wearable pharmaceutical delivery device is disclosed including a compressed elastic power source and a cylindrical pharmaceutical reservoir. Optionally, the compressed power source is positioned along a bent path. Alternatively or additionally, the compressed power source may power discharge of the pharmaceutical. Alternatively or additionally, the compressed power source may power extension of an injection needle. In some embodiments, a tensile element may activate an indicator when delivery of the pharmaceutical is complete.

Abstract: Systems and apparatuses for use with a guidewire are provided. The systems/apparatuses can include a first housing, shaped to define a first channel through which the guidewire is slidable and a second housing, shaped to define a second channel through which the guidewire is slidable in at least a first direction toward the first housing. The systems/apparatuses can also include a guidewire-engaging element, disposed within the second housing, and configured to inhibit the guidewire from sliding through the second channel in a second direction away from the first housing. A tubular member having a lumen through which the guidewire is slidable and being slidably coupled to the first housing can also be included. 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: During a percutaneous procedure, a flexible sleeve of an annuloplasty structure is introduced into an atrium and arranged completely around an annulus as a closed loop, such that none of one or more longitudinal contracting members thereof is positioned along an anterior portion of the annulus between fibrous trigones of the valve. The annuloplasty structure is fastened to the annulus. At least a portion of a posterior portion of the annulus is tightened, while preserving a length of an anterior portion of the annulus between fibrous trigones of the valve, by contracting, using the one or more longitudinal contracting members, a longitudinal portion of the sleeve not positioned along the anterior portion of the annulus between the fibrous trigones of the valve. Thereafter, the one or more longitudinal contracting members are locked.

Abstract: Apparatus for use with a guidewire is provided, the apparatus including (1) a first housing, shaped to define a first channel through which the guidewire is slidable; (2) a second housing, shaped to define a second channel through which the guidewire is slidable in at least a first direction toward the first housing; (3) a guidewire-engaging element, disposed within the second housing, and configured to inhibit the guidewire from sliding through the second channel in a second direction away from the first housing; and (4) a tubular member, (a) shaped to define a lumen therethrough, through which the guidewire is slidable, and (b) coupled to the second housing and slidably coupled to the first housing. Other embodiments are also described.

Abstract: Anchor deployment systems and tools are provided. An anchor deployment tool can include a flexible tube including a distal anchor manipulation portion. The tool can also include a deployment element, which is positionable within the flexible tube, and is configured to, while the distal anchor manipulation portion is proximate an implantable device, (i) engage the anchors in the flexible tube, (ii) advance each of the anchors in a distal direction to the distal anchor manipulation portion, and (iii) anchor the implantable device to tissue of a subject by deploying each of the tissue anchors through the implantable device and into the tissue.

Abstract: A needle insertion and retraction mechanism for a drug delivery device, comprises a motion source, a user-operated control for the motion source, an interrupter for stopping motion of the motion source at a predetermined location and thereby dividing the motion into two parts which are continuous relative to each other. A motion translation mechanism connects the source of continuous motion to a needle, to extend the needle during the first motion part and to retract the needle during the second motion part. The needle is thus extended and retracted by continued operation of a single tension source rather than two tension sources operating in opposition to each other. The motion source may be a spring, and a winding mechanism may be provided to wind the spring. The second motion part may be initiated by pulling the adhered delivery device from the skin.

Abstract: Apparatus is provided for repairing a cardiac valve, the apparatus can include a flexible annuloplasty structure having a sleeve with an elongated tubular side wall and a distal tip. A first tissue anchor can passing through the distal tip of the sleeve, and a second tissue anchor can pass through a section of the tubular side wall. The first and second tissue anchors can extend in a substantially same direction. A longitudinal portion of the tubular side wall can be disposed between the first and second tissue anchors, and have a first lateral part opposite a second lateral part and closer to the first and second tissue anchors than the second lateral part is to the first and second tissue anchors. The second lateral part can have a degree of tension that is larger than a degree of tension of the first lateral part.

Abstract: A method is provided including introducing into a heart atrium, an annuloplasty structure having a sleeve with an elongated tubular side wall, anchoring a first section of the sleeve by deploying a first tissue anchor through the first section and into a first portion of annulus tissue, and anchoring a second section of the sleeve by deploying a second tissue anchor through the second section and into a second portion of annulus tissue. A longitudinal portion of the tubular side wall is disposed between the first and second tissue anchors and has first and second lateral parts. The first lateral part is closer to the annulus than the second lateral part is to the annulus, and the second lateral part is opposite the first lateral part and has a larger degree of tension than a degree of tension of the first lateral part.

Abstract: A system and method are provided for preventing a sharp stick hazard from a needle tip of an automatic injector device. In some embodiments, a skin contact surface of the device is attached to an injection site, for example by an adhesive. Optionally a locking mechanism holds a needle extended into an injection site. A body of the device is optionally movably attached to the skin contact surface. Pulling the body away from the injection site optionally moves the body with respect to the skin contact surface. Movement of the body with respect to the skin contact surface optionally moves interlinked parts of the locking mechanism, releasing the locking mechanism.

Abstract: Anchor deployment systems and tools are provided. An anchor deployment tool can include a flexible tube including a distal anchor manipulation portion. The tool can also include a deployment element, which is positionable within the flexible tube, and is configured to, while the distal anchor manipulation portion is proximate an implantable device, (i) engage the anchors in the flexible tube, (ii) advance each of the anchors in a distal direction to the distal anchor manipulation portion, and (iii) anchor the implantable device to tissue of a subject by deploying each of the tissue anchors through the implantable device and into the tissue.

Abstract: Apparatus is provided for repairing a cardiac valve, the apparatus including a catheter sized for delivery through vasculature of a subject and an elongated and flexible annuloplasty structure having an elongated lumen and an annuloplasty structure axis extending along the lumen. The annuloplasty structure is sized and configured for delivery to a heart of the subject through the catheter substantially along a catheter axis of the catheter while the annuloplasty structure axis is substantially parallel to the catheter axis. The apparatus also includes a plurality of anchors configured for delivery to a region of cardiac tissue from a proximal end of the catheter toward a distal end of the catheter and substantially along the annuloplasty structure axis and the catheter axis while at least a portion of the annuloplasty structure is within a delivery passage of the catheter. Other embodiments are also described.

Abstract: A catheter, advanced toward an anatomical site, has a proximal end and a steerable distal end. An anchor is advanced through the catheter. An anchor driver drives the anchor out of the catheter's distal end, anchoring the anchor at the site. A first constraining member engages tissue, and inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a first axis between the anchor driver's distal end and a site at which the first constraining member engages the tissue. A second constraining member inhibits, after the anchor has been driven out of the catheter and before the anchoring, movement of at least the anchor driver's distal end, on a second axis. Other embodiments are also described.

Abstract: A prosthetic valve comprises a valve body, comprising a tubular frame and a plurality of leaflets; an upstream support, comprising a second frame; and a flexible sheet that couples the upstream support to the valve body. The prosthetic valve is compressible into a delivery tool such that the prosthetic valve is in a compressed state in which the second frame and the tubular frame are arranged in series within the tool, and the valve body has a compressed body-diameter. The prosthetic valve is deployable from the tool such that the prosthetic valve automatically expands into an expanded state. In the expanded state, the second frame defines an inner perimeter, the sheet extends inwardly from the inner perimeter to the valve body, and the prosthetic valve defines a conduit through the upstream support and the valve body. Other embodiments are also described.