Abstract: Apparatus is provided, including a tissue-adjusting member configured to be coupled to tissue of a patient, a rotatable structure that is configured to adjust a tension of the tissue-adjusting member, a tissue anchor coupled to the tissue-adjusting member and configured to screw into the tissue of the patient, and a delivery tool reversibly coupleable to the rotatable structure. The delivery tool comprises a first actuating element configured to rotate the tissue anchor so as to facilitate screwing of the tissue anchor into the tissue of the patient while not facilitating rotation of the rotatable structure, and a second actuating element configured to rotate the rotatable structure while not facilitating rotation of the tissue anchor. Other applications 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 for use with at least one leaflet-engaging element, the apparatus including a delivery tool which includes an inner shaft, a surrounding shaft, and at least one leaflet-engaging element holder coupled to a portion of the surrounding shaft, the leaflet-engaging-element holder being shaped to define at least one coupling site for reversibly coupling the leaflet-engaging element to the tool. The surrounding shaft surrounds a portion of the inner shaft and is slidable along the inner shaft so as to position the leaflet-engaging holder in a vicinity of at least one leaflet of an atrioventricular valve of a patient. A distal end of the inner shaft is advanceable between leaflets of the atrioventricular valve and toward a tissue site of a ventricle of the patient. Other applications are also described.

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 adjusting at least one dimension of an implant, including a rotatable structure having first and second openings and a channel extending between the first and second openings. The channel allows passage therethrough of an elongate tool. The second end of the structure has a lower surface having one or more recesses along a circumference thereof. A mechanical element provides a protrusion that is disposed within one of the recesses of the rotatable structure during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure. The mechanical element includes a depressible portion coupled to the protrusion disposed in communication with the second opening of the lower surface, and configured to dislodge the protrusion from within the recess in response to a force applied thereto by the elongate tool. Other applications are also described.

Abstract: A method and device is provided, including implanting, at an intraventricular site of a ventricle of a patient, a spool coupled to a first end portion of a longitudinal member, and coupling a second end portion of the longitudinal member to a portion of tissue facing a lumen of the ventricle. Other embodiments are also described.

Abstract: Apparatus is provided, including a tissue-adjusting member configured to be coupled to tissue of a patient, a rotatable structure that is configured to adjust a tension of the tissue-adjusting member, a tissue anchor coupled to the tissue-adjusting member and configured to screw into the tissue of the patient, and a delivery tool reversibly coupleable to the rotatable structure. The delivery tool comprises a first actuating element configured to rotate the tissue anchor so as to facilitate screwing of the tissue anchor into the tissue of the patient while not facilitating rotation of the rotatable structure, and a second actuating element configured to rotate the rotatable structure while not facilitating rotation of the tissue anchor. Other applications are also described.

Abstract: A method is provided, including advancing a distal end of an inner shall of a delivery tool between leaflets of an atrioventricular valve, of a patient and into a ventricle of the patient. The method further includes, while maintaining the distal end of the inner shaft in place and within the ventricle, proximally withdrawing a surrounding shaft of the delivery tool with respect to the distal end of the inner shaft and toward the leaflets. This surrounding shaft surrounds a portion of the inner shaft. The method additionally includes using the surrounding shaft to engage at least one of the leaflets with at least one leaflet-engaging element. After engaging, the distal end of the inner shaft is proximally withdrawn from within the ventricle. Other applications are also described.

Abstract: A method is provided, including positioning, at an intraventricular site of a ventricle of a patient, a spool coupled to a first end portion of a longitudinal member and coupling a second end portion of the longitudinal member to a portion of tissue facing a lumen of the ventricle. Other embodiments are also described.

Abstract: Apparatus is provided for adjusting at least one dimension of an implant, including a rotatable structure having first and second openings and a channel extending between the first and second openings. The channel allows passage therethrough of an elongate tool. The second end of the structure has a lower surface having one or more recesses along a circumference thereof. A mechanical element provides a protrusion that is disposed within one of the recesses of the rotatable structure during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure. The mechanical clement comprises a depressible portion coupled to the protrusion disposed in communication with the second opening of the lower surface, and configured to dislodge the protrusion from within the recess in response to a force applied thereto by the elongate tool. Other applications are also described.

Abstract: A method is provided, including implanting, at an intraventricular site of a ventricle of a patient, a spool coupled to a first end portion of a longitudinal member, and coupling a second end portion of the longitudinal member to a portion of tissue facing a lumen of the ventricle. Other embodiments are also described.