Abstract: Apparatus and methods are described including identifying a subject as suffering from a condition selected from the group consisting of: cardiac dysfunction, congestive heart failure, reduced renal blood flow, increased renal vascular resistance, arterial hypertension, and kidney dysfunction. In response thereto, blood pressure within a renal vein (32) of the subject is reduced, by placing a blood pump (150) inside the subject's renal vein and activating the impeller to pump blood from the renal vein into the subject's vena cava (26). Other applications are also described.

Abstract: A cardiac valve prosthesis for implantation at a native valve having leaflets includes a distal fixation member configured to be implanted downstream of a native valve and includes engagement arms configured to apply, to a native valve's downstream side, a first force directed upstream, when the distal fixation member is implanted. The number of engagement arms matches the number of native valve leaflets. The prosthesis also includes a proximal fixation member configured to be implanted at least partially upstream of the native valve such that the proximal fixation member applies, to a native valve's upstream side, a second force directed downstream when the proximal fixation member is implanted. The application of the first and second forces is configured to couple the prosthesis to the native valve. The engagement arms and the proximal fixation member are configured to capture the leaflets of the native valve therebetween.

Abstract: Apparatus and methods are provided, including a mitral valve prosthesis for implantation at a native mitral valve complex of a subject. The prosthesis includes an inner support structure having a downstream section, and an upstream section, the upstream section having a cross-sectional area greater than the downstream section, the inner support structure being configured to be positioned at least partially on an atrial side of the native valve complex, and to apply an axial force directed toward a left ventricle. The prosthesis further includes an outer support structure having two or more engagement arms, the engagement arms being coupled to the inner support structure. The prosthesis is configured, upon implantation thereof, to clamp portions of leaflets of the native valve between the inner support structure and the engagement arms. Other embodiments are also described.

Abstract: In some embodiments, an apparatus includes a valve prosthesis for attachment to a native valve complex of a subject. The prosthesis is configured to assume a compressed delivery state and an uncompressed implantation state. The prosthesis includes a support frame, which is shaped so as to define an upstream inlet having upstream-most portions that are tapered in an upstream direction toward a central longitudinal axis of the prosthesis when the prosthesis assumes the compressed delivery state, and a flexible prosthetic heart valve component, coupled to the support frame. Other embodiments are also described.

Abstract: Apparatus and methods are described including a valve (34) that includes valve leaflets (33) and a non-branched valve frame (31) configured to support the valve leaflets, the frame defining a single longitudinal axis thereof, the longitudinal axis being a generally straight line along a full length of the frame. The valve (34) is placed at least partially within a renal vein of a subject. The valve defines an open state thereof in which the valve leaflets (33) allow generally unimpeded antegrade blood flow therethrough, and a closed state thereof in which the valve leaflets (33), in a passive manner, reduce venous pressure within the renal vein relative to central venous pressure of the subject. Other applications are also described.

Abstract: Apparatus and methods are described including inserting a catheter into a subject's body via a vein of the subject's groin. The catheter is advanced distally such that a distal end of the catheter is disposed inside the subject's renal vein. Respective stabilizing portions of the catheter stabilize the catheter by being in contact with inner walls of, respectively, an iliac vein of the subject, and a vena cava of the subject. Subsequently, a medical device is deployed inside the renal vein by retracting the distal end of the catheter, such that the distal end of the catheter is in a retracted state, in which the respective stabilizing portions of the catheter still stabilize the catheter by being in contact with the inner walls of, respectively, the subject's iliac vein and the subject's vena cava. Other applications are also described.

Abstract: A cardiac valve prosthesis for implantation at a native valve having leaflets includes a distal fixation member configured to be implanted downstream of a native valve and includes engagement arms configured to apply, to a native valve's downstream side, a first force directed upstream, when the distal fixation member is implanted. The number of engagement arms matches the number of native valve leaflets. The prosthesis also includes a proximal fixation member configured to be implanted at least partially upstream of the native valve such that the proximal fixation member applies, to a native valve's upstream side, a second force directed downstream when the proximal fixation member is implanted. The application of the first and second forces is configured to couple the prosthesis to the native valve. The engagement arms and the proximal fixation member are configured to capture the leaflets of the native valve therebetween.

Abstract: Apparatus is provided including a prosthesis for implantation at a native semilunar valve of a native valve complex of a subject, the native valve complex having semilunar sinuses, the prosthesis including a valve prosthesis support, which includes a support structure including at least two engagement arms. Upon implantation of the prosthesis, each of the engagement arms is at least partially disposed within a respective one of the semilunar sinuses. A shape of at least one of the engagement arms is generally characterized by a function z?(r)>=0, where z is a height of any given point on the at least one engagement arm measured along a longitudinal axis of the prosthesis, and r is a distance from the longitudinal axis to the given point. Other embodiments are also described.

Abstract: A prosthesis is provided for implantation at a native semilunar valve of a native valve complex. The prosthesis includes a distal fixation member, configured to be positioned in a downstream artery, and to apply a first axial force directed toward a ventricle. The prosthesis further includes a proximal fixation member coupled to the distal fixation member, the proximal fixation member configured to be positioned at least partially on a ventricular side of the native valve complex, and to apply a second axial force directed toward the downstream artery, such that application of the first and second forces couples the prosthesis to the native valve complex by axially sandwiching the native valve complex from a downstream side and the ventricular side thereof. The prosthesis is configured, upon implantation thereof, to embrace, without squeezing, leaflets of the native semilunar valve. Other embodiments are also described.

Abstract: A loading tool for withdrawing, crimping, and loading a stent-mounted valve into a delivery catheter, and for pushing the stent-mounted valve from the delivery catheter into a native heart valve orifice. The loading tool comprises at least one connector adapted for being removably connected to the stent of the stent-mounted valve. A crimping tool having a generally converging shape is adapted for use with the loading tool. Following connection of the loading tool to the stent-mounted valve, the loading tool operates to allow the stent-mounted valve to be drawn through the crimping tool, and loaded, in a crimped state, into a delivery catheter. Also disclosed is a kit of the of the various components for effecting the delivery of the stent-mounted valve and a method for withdrawing, crimping, and loading a stent-mounted valve from a storage container into a delivery catheter for the performance of a transcatheter valve implantation procedure.

Abstract: Apparatus is provided for implanting a prosthetic device (108) in a patient, the apparatus includes a trocar tube (101), a first portion of which is configured to be placed in a left ventricle (12) of the patient during a procedure for implantation of the prosthetic device (108), and a second portion of which is configured to be placed in an extracardiac location during the procedure. The first portion is shaped so as to define at least one opening to an interior thereof. One or more flexible bypass tubes (103, 104, 106), each of which is coupled to the second portion, and each of which is configured to be coupled to at least one artery (20, 21, 30) of the patient, so as to create a blood flow bypass path during the procedure, from the left ventricle (12), via the opening and the bypass tubes (103, 105, 106), to the at least one artery (20, 21, 30). Other embodiments are also described.

Abstract: A prosthesis is provided for implantation at a native semilunar valve of a native valve complex. The prosthesis includes a distal fixation member, configured to be positioned in a downstream artery, and shaped so as to define exactly three proximal engagement arms that are configured to be positioned at least partially within respective ones of semilunar sinuses, and, in combination, to apply, to tissue that defines the semilunar sinuses, a first axial force directed toward a ventricle. The prosthesis further includes a proximal fixation member coupled to the distal fixation member, the proximal fixation member configured to be positioned at least partially on a ventricular side of the native semilunar valve, and to apply, to the ventricular side of the native valve complex, a second axial force directed toward the downstream artery, such that application of the first and second forces couples the prosthesis to the native valve complex.

Abstract: A prosthesis including a distal fixation member that defines two or more engagement arms that are configured to apply a first axial force to tissue of the subject on a downstream side of the native valve complex. The prosthesis also includes a proximal fixation member configured to apply a second axial force to tissue of the subject on an upstream side of the native valve complex such that application of the first and second axial forces couples the prosthesis to the native valve complex. The proximal fixation member and the distal fixation member are fabricated as one integrated structure. The engagement arms and the proximal fixation member are configured to capture leaflets of the native valve complex therebetween without folding over of leaflets of the native valve complex, upon implantation of the prosthesis.

Abstract: A method for implanting a valve prosthesis at a native cardiac valve complex of a subject comprises implanting a distal fixation member of the valve prosthesis downstream of a native valve of the native valve complex such that two or more engagement arms of the distal fixation member apply, to a downstream side of the native valve, a first axial force directed upstream. The method also comprises implanting a proximal fixation member of the valve prosthesis at least partially upstream of the native valve, such that the proximal fixation member applies, to an upstream side of the native valve, a second axial force directed downstream, such that application of the first and second forces couples the valve prosthesis to the native valve complex. The engagement arms and the proximal fixation member capture leaflets of the native valve therebetween without folding over leaflets of the native valve.

Abstract: A loading tool for withdrawing, crimping, and loading a stent-mounted valve into a delivery catheter, and for pushing the stent-mounted valve from the delivery catheter into a native heart valve orifice. The loading tool comprises at least one connector adapted for being removably connected to the stent of the stent-mounted valve. A crimping tool having a generally converging shape is adapted for use with the loading tool. Following connection of the loading tool to the stent-mounted valve, the loading tool operates to allow the stent-mounted valve to be drawn through the crimping tool, and loaded, in a crimped state, into a delivery catheter. Also disclosed is a kit of the of the various components for effecting the delivery of the stent-mounted valve and a method for withdrawing, crimping, and loading a stent-mounted valve from a storage container into a delivery catheter for the performance of a transcatheter valve implantation procedure.

Abstract: A suturing device for use with a delivery catheter in a transcatheter procedure, for closing an opening formed in the body. The suturing device includes: a spiral needle having a central core, a proximal end, and a distal end. The distal end terminates in a sharp point for cutting a spiral passageway through body tissue surrounding the opening that is to be closed. The device also includes a guide wire having a suture eye at one end thereof for receiving suture thread after the guide wire has been advanced through the hollow central core of the spiral needle. The device further includes driving means, for allowing advancing and retracting of the spiral needle and guide wire with respect to the catheter, and for allowing connecting between the suture thread and the suture eye of the guide wire.

Abstract: Apparatus and methods are provided, including a plurality of anchoring elements, each of the anchoring elements being an elongate element that is curved to define an opening. A housing holds each of the anchoring elements. A mandrel is reversibly disposable through the openings defined by the anchoring elements. The anchoring elements are configured such that, in response to removal of the mandrel from the openings, ends of the anchoring elements automatically move outwardly, and diameters of the openings decrease, due to elastic loading of the anchoring elements. Other embodiments are also described.

Abstract: A prosthesis is provided for implantation at a native semilunar valve of a native valve complex, the native valve complex having three semilunar sinuses and three native commissures. The prosthesis includes a valve prosthesis support, which comprises a support structure comprising exactly three engagement arms that meet one another at three respective junctures. The engagement arms are shaped so as define three peak complexes at the three respective junctures, and three trough complexes, each of which is between two of the peak complexes. Upon implantation of the prosthesis, each of the engagement arms is at least partially disposed within a respective one of the semilunar sinuses, such that each of the peak complexes is disposed distal to and in rotational alignment with a respective one of the native commissures, and each of the trough complexes is disposed at least partially within the respective one of the semilunar sinuses.

Abstract: In some embodiments, an apparatus includes a valve prosthesis for attachment to a native valve complex of a subject. The prosthesis is configured to assume a compressed delivery state and an uncompressed implantation state. The prosthesis includes a support frame, which is shaped so as to define an upstream inlet having upstream-most portions that are tapered in an upstream direction toward a central longitudinal axis of the prosthesis when the prosthesis assumes the compressed delivery state, and a flexible prosthetic heart valve component, coupled to the support frame. Other embodiments are also described.

Abstract: A prosthesis is provided for implantation at a native semilunar valve of a native valve complex. The prosthesis includes a distal fixation member, configured to be positioned in a downstream artery, and to apply a first axial force directed toward a ventricle. The prosthesis further includes a proximal fixation member coupled to the distal fixation member, the proximal fixation member configured to be positioned at least partially on a ventricular side of the native valve complex, and to apply a second axial force directed toward the downstream artery, such that application of the first and second forces couples the prosthesis to the native valve complex by axially sandwiching the native valve complex from a downstream side and the ventricular side. A ratio of the first axial force to a radial force applied outwardly by the prosthesis against the native semilunar valve is greater than 1.5:1. Other embodiments are also described.