Abstract: Apparatus and methods are described including an implant structure configured to treat a native atrioventricular valve of a patient, the implant structure including a sleeve having a lumen and at least one end, the at least one end being shaped so as to define an opening. A closure element is disposed in a vicinity of the at least one end, the closure element being configured to facilitate closure of the opening. A contracting mechanism is coupled to the implant structure and configured to contract at least a contraction-facilitated portion of the implant structure. Other applications are also described.

Abstract: An implantable structure includes a flexible sleeve, having first and second sleeve ends, and a contracting assembly, which is configured to longitudinally contract the sleeve, and includes a contracting mechanism, which is disposed longitudinally at a first site of the sleeve, and a longitudinal contracting member, having (a) a first member end, (b) a second member end, which is coupled to the sleeve longitudinally at a second site longitudinally between the first site and the second sleeve end, exclusive, and (c) a first member end portion, which is coupled to the contracting mechanism. The sleeve is arranged in a closed loop, such that first and second portions of the sleeve together define a longitudinally overlapping portion of the sleeve. The implantable structure is configured such that the contracting assembly longitudinally applies a longitudinal contracting force only between the first and the second sites, and not along the overlapping portion.

Abstract: An anchor driver is provided that includes a driver head having a flexible ring. An anchor is provided that includes a coupling head, which is shaped so as to define: (a) one or more mating elements that engage mechanical coupling elements of the driver head such that rotation of the mechanical coupling elements rotates the mating elements, which in turn rotate the coupling head, and (b) an outer coupling surface, sized to be inserted into and engage the flexible ring. The anchor also includes a tissue coupling element fixed to the coupling head. The rotation of the mechanical coupling elements causes the tissue coupling element of the anchor to screw itself into tissue, thereby causing separation of: (a) the outer coupling surface of the coupling head from the flexible ring, and (b) the mating elements of the coupling head from the corresponding mechanical coupling elements. Other embodiments are also described.

Abstract: Apparatus for percutaneous access to a patient's body comprising a first steerable tube (12), shaped to define a first lumen, and a first coupling (152) at a longitudinal site of the first tube; and a second steerable tube (14), shaped to define a second lumen and a second coupling (154), the second coupling being intracorporeally couplable to the first coupling, the apparatus having (A) an unlocked state in which the second tube is rotatable within the first lumen, and (B) a locked state in which the second coupling is coupled to the first coupling, and rotation of the second tube is inhibited. The apparatus is configured such that when the second coupling becomes disposed at the longitudinal site in a given rotational orientation of the second tube, the apparatus moves into the locked state by the second coupling automatically coupling to the first coupling. Other embodiments are also described.

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: Apparatus is provided, including a first catheter having a distal end portion transluminally advanceable to a vicinity of an anatomical site, a second catheter having a distal end portion advanceable through a first lumen and out of the first lumen, and a longitudinal implant, advanceable through the second lumen and out of the second lumen. The first and second catheters are assembled to facilitate sliding of the first and second catheters and of the implant, to configure them to assume a multi-bend formation having first and second bends separating first, second, and third domains. The first domain includes parts of the first and second catheters. The second domain includes the distal end portion of the second catheter, part of the implant, and none of the first catheter. The third domain includes part of the implant and none of the first nor second catheters. Other embodiments are also described.

Abstract: Apparatus is provided including an implantable structure (22), including a flexible sleeve (26), having first and second sleeve ends (49, 51), a contracting assembly (40), which is configured to longitudinally contract the sleeve (26). The contracting assembly (40) includes a contracting mechanism (28), which is at a first site of the sleeve (26); and a longitudinal contracting member (30), having (a) a first member end, (b) a second member end (53), coupled to the sleeve (26) at a second site longitudinally between the first site and the second sleeve end (49 or 51), exclusive. A force-distributing element (540) is couplable to the sleeve (26) in a vicinity of the second sleeve end (49 or 51), element (540) is configured to distribute a contraction force by the contracting member (30) between the second member end (53) and the second sleeve end (49 or 51). Other applications are also described.

Abstract: Apparatus is provided that includes an implant structure, which includes a contracting mechanism, which includes a rotatable structure, arranged such that rotation of the rotatable structure contracts the implant structure. A longitudinal member is coupled to the contracting mechanism. A tool for rotating the rotatable structure is configured to be guided along the longitudinal member, to engage the rotatable structure, and to rotate the rotatable structure in response to a rotational force applied to the tool. Other embodiments are also described.

Abstract: Apparatus is provided that includes an implant structure, which includes a contracting mechanism, which includes a rotatable structure, arranged such that rotation of the rotatable structure contracts the implant structure. A longitudinal member is coupled to the contracting mechanism. A tool for rotating the rotatable structure is configured to be guided along the longitudinal member, to engage the rotatable structure, and to rotate the rotatable structure in response to a rotational force applied to the tool. Other embodiments are also described.

Abstract: An anchor deployment tool includes a flexible outer tube, within which is positioned a flexible inner shaft, and a rotating deployment element coupled to a distal end of the shaft. The tool is configured to provide an anchor storage area, which initially stores a plurality of tissue anchors, such that the inner shaft passes through channels of the anchors along entire longitudinal lengths of the anchors, and the anchors are within the outer tube. The rotating deployment element is configured to directly engage the anchors in the anchor storage area one at a time, advance each of the anchors while engaged in a distal direction, and deploy each of the anchors through the distal tube end and into tissue of a subject. Other embodiments are also described.

Abstract: An implantable structure includes a flexible sleeve, having first and second sleeve ends, and a contracting assembly, which is configured to longitudinally contract the sleeve, and includes a contracting mechanism, which is disposed longitudinally at a first site of the sleeve, and a longitudinal contracting member, having (a) a first member end, (b) a second member end, which is coupled to the sleeve longitudinally at a second site longitudinally between the first site and the second sleeve end, exclusive, and (c) a first member end portion, which is coupled to the contracting mechanism. The sleeve is arranged in a closed loop, such that first and second portions of the sleeve together define a longitudinally overlapping portion of the sleeve. The implantable structure is configured such that the contracting assembly longitudinally applies a longitudinal contracting force only between the first and the second sites, and not along the overlapping portion.

Abstract: Apparatus and methods are described including an implant structure configured to treat a native atrioventricular valve of a patient, the implant structure including a sleeve having a lumen and at least one end, the at least one end being shaped so as to define an opening. A closure element is disposed in a vicinity of the at least one end, the closure element being configured to facilitate closure of the opening. A contracting mechanism is coupled to the implant structure and configured to contract at least a contraction-facilitated portion of the implant structure. Other applications are also described.

Abstract: Apparatus is provided for use with a subject, including an implant comprising a sleeve shaped so as to define a lumen therein, the sleeve having first and second portions. A contracting mechanism is coupled to a portion of an outer surface of the sleeve in a vicinity of the first portion of the sleeve. An elongated contracting member is coupled at a first end portion thereof to the contracting mechanism, and coupled at a second end portion thereof to the sleeve in a vicinity of the second portion of the sleeve. The contracting mechanism comprises a driving interface that is positioned so as to be accessible from the portion of the outer surface of the sleeve. The contracting mechanism is configured such that rotation of the driving interface contracts the implant by tightening the elongated contracting member. Other applications are also described.

Abstract: Apparatus and methods are described including an annuloplasty structure configured for implantation along an annulus of an atrioventricular valve of a heart of a subject. The structure includes a coiled element comprising at least one first portion thereof which is flexible and longitudinally compressible, and at least one second portion thereof in series with the first portion, the second portion being flexible and less longitudinally compressible than the first portion. Other applications are also described.

Abstract: An anchor deployment tool includes a flexible outer tube, within which is positioned a flexible inner shaft, and a rotating deployment element coupled to a distal end of the shaft. The tool is configured to provide an anchor storage area, which initially stores a plurality of tissue anchors, such that the inner shaft passes through channels of the anchors along entire longitudinal lengths of the anchors, and the anchors are within the outer tube. The rotating deployment element is configured to directly engage the anchors in the anchor storage area one at a time, advance each of the anchors while engaged in a distal direction, and deploy each of the anchors through the distal tube end and into tissue of a subject. Other embodiments are also described.

Abstract: An anchor driver is provided that includes a driver head having a flexible ring. An anchor is provided that includes a coupling head, which is shaped so as to define: (a) one or more mating elements that engage mechanical coupling elements of the driver head such that rotation of the mechanical coupling elements rotates the mating elements, which in turn rotate the coupling head, and (b) an outer coupling surface, sized to be inserted into and engage the flexible ring. The anchor also includes a tissue coupling element fixed to the coupling head. The rotation of the mechanical coupling elements causes the tissue coupling element of the anchor to screw itself into tissue, thereby causing separation of: (a) the outer coupling surface of the coupling head from the flexible ring, and (b) the mating elements of the coupling head from the corresponding mechanical coupling elements. Other embodiments are also described.

Abstract: Apparatus is provided that includes an implant structure, which includes a contracting mechanism, which includes a rotatable structure, arranged such that rotation of the rotatable structure contracts the implant structure. A longitudinal member is coupled to the contracting mechanism. A tool for rotating the rotatable structure is configured to be guided along the longitudinal member, to engage the rotatable structure, and to rotate the rotatable structure in response to a rotational force applied to the tool. Other embodiments are also described.