Abstract: Holders for releasably holding annuloplasty rings prior to and during the implantation of the rings employ any of a variety of features relating to such things as holder shape, handle attachment structures, securement of a ring to the holder, and release of the ring from the holder.

Abstract: Improved sizers and markers include a cylindrical section and a handle extending from the cylindrical section. The cylindrical section has a diameter approximately equal to the diameter of an aortic heart valve prosthesis. The cylindrical section can include a marking element configured to mark tissue at fixed positions relative to the cylindrical section. Marking can be performed with a variety of techniques.

Abstract: A driver tool drives multiple fasteners simultaneously through the outer ring of a heart valve component into the surrounding tissue annulus of a heart. The driver tool includes two stacked satellite gear layers that drive flexible shafts that simultaneously drive the fasteners into tissue surrounding the heart valve component. The flexible shafts from the second drive gear layer can pass through gaps between satellite gears in the first drive gear layer. The number of fasteners is increased while maintaining the mechanical advantage of the tool and the size of the tool, and reducing the concentration of stress in the tissue annulus.

Abstract: Improved tools for visualizing, sizing and/or marking include a prosthesis template with a diameter approximately equal to the diameter of an aortic heart valve prosthesis. In preferred embodiments, the prosthesis template has an annulus end and a sinotubular junction end wherein the diameter at the annulus end is less than the diameter at the sinotubular junction end. The prosthesis template can include a marking element configured to mark tissue at particular positions relative to the prosthesis template. Marking can be performed with a variety of techniques.

Abstract: Improved sizers and markers include a cylindrical section and a handle extending from the cylindrical section. The cylindrical section has a diameter approximately equal to the diameter of an aortic heart valve prosthesis. The cylindrical section can include a marking element configured to mark tissue at fixed positions relative to the cylindrical section. Marking can be performed with a variety of techniques.

Abstract: An apparatus for holding an annuloplasty ring includes a holder body configured to hold the ring. A handle coupling attaches to a handle. A release mechanism on the handle coupling selectively releases the handle from the handle coupling.

Abstract: Improved sizers and markers include a cylindrical section and a handle extending from the cylindrical section. The cylindrical section has a diameter approximately equal to the diameter of an aortic heart valve prosthesis. The cylindrical section can include a marking element configured to mark tissue at fixed positions relative to the cylindrical section. Marking can be performed with a variety of techniques.

Abstract: Improved tools for visualizing, sizing and/or marking include a prosthesis template with a diameter approximately equal to the diameter of an aortic heart valve prosthesis. In preferred embodiments, the prosthesis template has an annulus end and a sinotubular junction end wherein the diameter at the annulus end is less than the diameter at the sinotubular junction end. The prosthesis template can include a marking element configured to mark tissue at particular positions relative to the prosthesis template. Marking can be performed with a variety of techniques.

Abstract: A holder is provided for carrying a prosthetic ring which allows for manipulation and handling of the ring during implantation in a heart. The holder includes a holder body configured to fit the ring. A boss extends around the holder body. A backing lip extends from a proximal end of the boss and has a diameter that is greater than a diameter of the boss. A shoulder tab extends only partially around the distal end of the boss and extends beyond a diameter of the boss. The prosthetic ring mates with the boss and the backing lip to thereby hold the prosthetic ring.

Abstract: An annuloplasty ring and support assembly includes a ring support that has a peripheral wall with a peripheral shoulder surface, and a flange extending at generally right angles to the shoulder surface. The flange is removed or terminated in a selected portion of the peripheral wall so that the shoulder surface is unobstructed and provides a backing support against which a cutting force will be reacted when the annuloplasty ring is cut.

Abstract: A prosthetic heart valve rotator tool operates in the small chest cavity available to the surgeon, having parts that can be easily assembled and disassembled, allowing it to be cleaned and sterilized for repeated use.