Abstract: The device (1) is intended to be positioned in a sealed introducer placed in a femoral vein in order to penetrate the left atrium (4) of the heart (3) by passing through the septal wall (5) thereof.

Abstract: An annuloplasty device formed from a Nitinol stent frame that expands into contact with the annulus above the native leaflets. A torus balloon activates barbs along the perimeter to fasten the stent frame to the annulus. A cinch ring is placed under tension to reduce the perimeter of the stent frame. The cinch ring and torus balloon are implanted along with the stent frame.

Abstract: A heart valve prosthesis delivery system can include a first sheath, a second sheath, a check valve, a check valve control lines, and a heart valve prosthesis carried within the first sheath or the second sheath. The check valve can be carried within the first sheath or the second sheath. The check valve has a check valve frame and a cover component, and the check valve control lines can be coupled to the check valve frame and configured to be manipulated by a physician to control release of the check valve. In use, the check valve can be configured to be deployed within the native valve structure for minimizing back flow of blood during placement of the valve prosthesis when the native valve leaflets are rendered non-functional by the presence of the delivery system.

Abstract: Systems and methods for docking a heart valve prosthesis. A system can include an anchor formed as multiple coils adapted to support a heart valve prosthesis with coil portions positioned above and below the heart valve annulus. At least one of the coil portions can normally be at a first diameter and be expandable to a second, larger diameter upon application of radial outward force from within the helical anchor. Methods can include delivering an anchor, positioning and implanting a heart valve prosthesis, and expanding the heart valve prosthesis inside the anchor.

Abstract: A prosthetic implant includes a circumferentially adjustable sealing collar and a rotatable sealer gear. The sealing collar has a central longitudinal axis. The rotatable sealer gear is coupled to and disposed within the sealing collar and configured to adjust the circumference of the sealing collar. The sealer gear is radially offset relative to the central longitudinal axis of the sealing collar. Rotating the sealer gear in a first direction relative to the sealing collar circumferentially expands the sealing collar. Rotating the sealer gear in a second direction relative to the sealing collar circumferentially contracts the sealing collar.

Abstract: A replacement valve for replacing a damaged heart valve having a plurality of cusps separating an upstream region from a downstream region of a passage. The replacement valve includes a flexible band having biocompatible scaffolding sized for contact with a wall surrounding the passage in the patient's heart. The valve includes a resilient element attached to the flexible band for expanding the flexible band to contact the wall of the passage. The valve includes regenerative struts spaced around the flexible band. Each strut extends from an outboard end joined to an inward face of the flexible band to a central end. The central ends of the struts are joined together. The valve includes a flexible regenerative membrane joined to adjacent struts. The membrane extends outboard to an inward face of the band. An outboard edge of the membrane is free to move between a closed position and an open position.

Abstract: A mitral cerclage annuloplasty apparatus comprises a tissue protective device and a knot delivery device. The tissue protective device comprises a first protective tube and a second protective tube. The knot delivery device comprises a tube wherein a loose knot is looped around its distal end through a hole and wherein tight knot is formed when the distal end of the tube is cut open. Alternatively, the knot delivery device comprises an inner tube and outer tube. The inner tube is insertable and rotatable inside the outer tube. When the tubes are in a closed position by rotating either the outer tube or the inner tube, a hole is created near its distal end. When the tubes are in open position by rotating either the outer tube or the inner tube, the hole joins the opening of the outer tube and lengthens.

Abstract: A device (100) for supporting a valve annulus is described that includes spaced apart support members (105) and a connecting member (110) extending between and connecting the support members. At least one adjustor (115) is also provided that is engaged with the connecting member and can be actuated to modify a length of the connecting member between two adjacent support members. In addition, each support member may include at least two channels extending through the support members at different heights with respect to an overall thickness of the respective support member. Each channel may receive a portion of the connecting member therethrough, and each support member may further include a passageway between the channels to allow selection of one of the channels. In this way, the device may be adjusted in at least two dimensions to support the valve leaflets and promote sufficient closure of the leaflets.

Abstract: Systems and methods for modifying a heart valve annulus in a minimally invasive surgical procedure. A helical anchor is provided, having a memory set to a coiled shape or state. The helical anchor is further configured to self-revert from a substantially straight state to the coiled state. The helical anchor is loaded within a needle that constrains the helical anchor to the substantially straight state. The needle is delivered to the valve annulus and inserted into tissue of the annulus. The helical anchor is then deployed from the needle (e.g., the needle is retracted from over the helical anchor). Once deployed, the helical anchor self-transitions toward the coiled shape, cinching engaged tissue of the valve annulus.

Abstract: The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices each includes a vascular anchor, an annulus anchor, and at least one tensioning member connecting with the vascular anchor or the annulus anchor. Another aspect of the present teachings provides methods of deploying a vascular anchor at a first treatment location inside the coronary sinus, and deploying an annulus anchor at a second treatment location across the tricuspid annulus. When both the anchors are pulled towards each other, the portion of the annulus between the two anchors is plicated, which improves the coaptation of the tricuspid valve leaflets.

Abstract: Anchors for securing an implant within a body organ and/or reshaping a body organ are provided herein. Anchors are configured for deployment in a body lumen or vasculature of the patient that are curved or conformable to accommodate anatomy of the patient. Such anchors can include deformable or collapsible structures upon tensioning of a bridging element in a lateral direction, or segmented tubes that can be adjusted by tightening of one or more tethers extending therethrough. Such anchors can be used as a posterior anchor in a blood vessel in implant systems having a tensioned bridging element extending between the posterior anchor and an anterior anchor deployed at another location within or along the body organ. Methods of deploying such anchors, and use of multiple anchors or multiple bridging elements to a single anchor are also provided.

Abstract: A portable X-ray imaging apparatus is prevented from losing a connection with a medical member when a detection element is set up in the proximity of the subject to carry out an X-ray imaging. The portable X-ray imaging apparatus 100 comprises an X-ray tube device 4 that irradiates an X-ray to a subject P, an X-ray receiver 6 that detects the X-ray that transmits the subject P, a housing 1b that houses the X-ray receiver 6 capable of being pulled out, and a control element 21 that provides an alarm to prompt paying attention based on the connecting information 30a relative to a connection of the medical member with the subject P.

Abstract: An adjustable annuloplasty device comprising a tube having a basically annular shape or adopted to be brought into an annular shape. At least one portion, preferably three portions, of an outer wall or the whole outer wall of the tube is more rigid than opposite portion(s) of an inner wall or the whole inner wall. The inner wall is arranged nearer to an inside area defined by the annular shape than the outer wall. The inner wall is adapted to be displaced inwardly at least along less rigid portion(s) of the circumference upon actuation by at least one actuation element while the outer wall remains basically constant.

Abstract: A heart valve assembly includes a heart valve, a self-expandable and collapsible stent, and a sealing member. The stent includes an inflow end and an outflow end and is configured to support the heart valve internally. The sealing member is connected to and extends circumferentially around the stent. The sealing member includes a plurality of radially outward extending protrusions comprising a fold of material of the sealing member.

Abstract: Apparatus, systems, and methods are provided for percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves. An annuloplasty ring includes an outer tube, an inner body member, and an anchor deployment system. The outer tube includes a plurality of windows and has an axis along its length. The internal body member includes a plurality of anchors formed perpendicular to the axis. The anchor deployment system selectively rotates the internal body member with respect to the axis of the outer tube. The rotation deploys the plurality of anchors through the plurality of windows.

Abstract: A prosthetic valve including an inner frame, an outer frame, and a connection assembly interconnecting the frames. The inner frame defines an interior volume for receiving a valve structure within the interior volume. The outer frame surrounds the inner frame. The inner and outer frames are each configured to be transitionable between compressed and expanded conditions. The prosthetic heart valve provides a initial deployed state in which the inner and outer frames are in the expanded condition, and a radial shape of the outer frame is adjustable via the connection assembly to a final deployed state. A shape of the outer frame can be adjusted upon implant to enable radial anchoring at the native annulus, while addressing possible non-uniformities of the native annulus and possible anatomical concerns such as LVOT obstruction.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

Abstract: Sensor-integrated prosthetic valves that can comprise a variety of features, including a plurality of valve leaflets, a frame assembly configured to support the plurality of valve leaflets and define a plurality of commissure supports terminating at an outflow end of the prosthetic valve, a sensor device associated with the frame assembly and configured to generate a sensor signal, for example, a sensor signal indicating deflection of one or more of the plurality of commissure supports, and a transmitter assembly configured to receive the sensor signal from the sensor device and wirelessly transmit a transmission signal that is based at least in part on the sensor signal.

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 collapsible device, such as an annuloplasty ring or prosthetic heart valve, is configured to be collapsed prior to being introduced into a patient via minimally-invasive access points such as port holes or intercostal incisions. A holder is configured to hold the collapsible device, and to selectively collapse the device for introduction into the patient and then re-enlarge the device at the desired deployment site. Collapsible devices include devices that can hingedly fold about hinge lines, and devices that can elongate to form substantially spiral forms with reduced diameters.

Abstract: Sealable and repositionable implant devices are provided with one or more improvements that increase the ability of implants such as endovascular grafts to be precisely deployed or re-deployed, with better in situ accommodation to the local anatomy of the targeted recipient anatomic site, and/or with the ability for post-deployment adjustment to accommodate anatomic changes that might compromise the efficacy of the implant. A surgical implant includes an implant body and a selectively adjustable assembly attached to the implant body, having adjustable elements, and operable to cause a configuration change in a portion of the implant body and, thereby, permit implantation of the implant body within an anatomic orifice to effect a seal therein under normal physiological conditions.

Abstract: The invention relates in some aspects to a device for use in the transcatheter treatment of mitral valve regurgitation, including steerable guidewires, implantable coaptation assistance devices, anchoring systems for attaching a ventricular projection of an implantable coaptation device, a kit, and methods of using an implantable coaptation assistance device among other methods.

Abstract: An anchor anchors a therapeutic device having an elongated body within a body lumen. The anchor includes a fixation member carried on the device which is adjustable from a first configuration that permits placement of the device in the body lumen to a second configuration that anchors the device within the body lumen. The anchor further includes a lock that locks the fixation member in the second configuration. The fixation member may be locked in any one of a plurality of intermediate points between the first configuration and a maximum second configuration.

Abstract: In a surgical method for improving cardiac function, an implantable scaffold or valve support device is inserted inside a patient's heart and attached to the heart in a region adjacent to a natural mitral or other heart valve. The scaffold or valve support device defines an orifice and, after the attaching of the scaffold or valve support device to the heart, or temporary support while native valve leaflets and/or subvalvular structures are captured, a prosthetic or bio-prosthetic valve seated in the orifice, and the native valve may be retracted into the scaffold/replacement assembly to create a gasket for sealing the complex.

Abstract: One embodiment of the present invention includes a filamentary fixation system including a sleeve formed of filamentary material including an interior and an exterior surface along a length defined between a first end and a second end, the sleeve having a coating adapted to allow for tissue ingrowth, and a filament formed of filamentary material including a first free end and a second free end, and a length therebetween, at least a portion of the filament positioned within the interior of the sleeve.

Abstract: The present disclosure relates to repair devices and methods for repair of regurgitant tricuspid valves. A repair method includes positioning a repair device at a tricuspid valve in a collapsed configuration. The repair device includes a proximal disk and a distal disk joined by a neck section. The distal disk is deployed by passing it from the collapsed state to an expanded configuration on a first side of the tricuspid valve. The proximal disk is then deployed by passing it from the collapsed state to an expanded configuration on a second side of the tricuspid valve so as to grasp all three tricuspid valve leaflets between the deployed distal disk and the deployed proximal disk.

Abstract: An annuloplasty prosthesis and delivery system for implanting the prosthesis adjacent an annulus of a heart valve having leaflets for adjusting the annulus to improve valve function includes a ring prosthesis made of shape memory material and having tissue attachment members which attach to the annulus in the atrium and commissural legs extending from the ring between the leaflets and secure against the underside of the valve in the ventricle. The prosthesis is carried via an orientation loop and attaches to the heart tissue such that when the prosthesis is manipulated and relaxed the annulus is adjusted to reduce or eliminate regurgitation.

Abstract: A prosthetic system for heart valve replacement comprises an annular support structure within which a valved prosthetic body can be expanded until it meets opposition. The annular support is provided in ring segments having terminal connectors for forming, in the condition of use of the prosthetic system, a stable and durable annular structural continuity capable of withstanding the opposition exerted by the valved prosthetic body. The prosthetic system is deployed using guide wires within a cardiac chamber guided through an introducer catheter having through lumens, within which at least two first guide catheters are positioned. These guide catheters have respective deflected or deflectable distal ends adapted to emerge from the distal end of the introducer catheter to convey and direct the distal ends of respective guide wires, placed within the guide catheters, towards a capture member of a capture system which is provided within the introducer catheter.

Abstract: The present disclosure relates to an arrangement, a loop-shaped support, a prosthetic heart valve and a method of repairing or replacing a native heart valve. With the method or the arrangement, leakage or regurgitation between a prosthetic heart valve and the surrounding valve tissue is prevented. In one embodiment, an arrangement for replacement or repair of a native heart valve is provided, which comprises a loop-shaped support 41 and a prosthetic heart valve 70 and wherein an outer segment 32 of the loop-shaped support 41 is positionable towards surrounding valve tissue of a native heart valve and wherein an outer surface 74 of the prosthetic heart valve 70 is positionable towards an inner segment 34 of the loop-shaped support 41 so as to prevent paravalvular leakage or regurgitation between the prosthetic heart valve 70 and the surrounding valve tissue of the native heart valve.

Abstract: Various systems, devices and methods associated with the placement of a dock or anchor (72) for a prosthetic mitral valve (120). The anchor (72) may take the form of a helical anchor having multiple coils (104, 108) and/or a stent-like structure. Various methods include different levels of minimal invasive procedures for delivering the prosthetic valve anchor (72) and prosthetic valve (120), as well as tissue anchors for plication or other purposes to the mitral valve position in the heart (14).

Abstract: An annuloplasty ring holder including a head having an upper surface and an annuloplasty ring receiving surface facing opposite the upper surface. The annuloplasty ring holder also includes means for attaching an annuloplasty ring to the annuloplasty ring receiving surface. The means for attaching an annuloplasty ring to the annuloplasty ring receiving surface may include one or more suture guides operatively associated with the head and configured to position one or more sutures to removably associate an annuloplasty ring with the annuloplasty ring receiving surface. The head may include a central hub and more than one spoke radiating out from the central hub. If the head is thus configured, each spoke will include a portion of the annuloplasty ring receiving surface.

Abstract: Apparatus is provided, comprising a ring, comprising a plurality of struts arranged in a pattern of alternating peaks and troughs, each strut having a first end-portion and a second end-portion, each peak defined by convergence of adjacent first end-portions disposed at an angle with respect to each other, and each trough defined by convergence of adjacent second end-portions. The apparatus also comprises a plurality of anchors. Each anchor has a longitudinal axis, is configured to be driven along the longitudinal axis into tissue of the heart, and is coupled to the ring at a respective trough in a manner that facilitates (i) movement of the anchor along the longitudinal axis with respect to the trough, and (ii) deflection of the longitudinal axis with respect to the trough.

Abstract: A device for improving the function of a heart valve has a first and a second shape. The device comprises two contact points, and the device in the first shape exhibits a distance between the two contact points essentially corresponding to a distance between two commissures of the heart valve and the device in the second shape exhibits an increased distance between the contact points. The device is in the first shape arranged for insertion to the heart valve to establish a contact between the contact points and the commissures. The device is transferable from the first shape to the second shape, and the device is in the second shape arranged for extending in abutment with valve tissue throughout a cycle of heart action. The device may change the shape of the heart valve by stretching it between the commissures for improving the ability of the heart valve to close.

Abstract: A device for improving the function of a heart valve comprises: a support member formed from a shape memory material, and a restraining member providing a restraining action on a course of the support member. The support member may abut one side of the valve conforming to the shape of the valve annulus upon said shape memory material assuming an activated shape while the restraining member restrains the course of the support member. The restraining action is removable for allowing the support member to assume a desired, altered course. The restraining member may be biodegradable to be degraded within a patient or may be detachable from the support member to be withdrawn. The support member according to another embodiment presents a shape change in that an increased cross-section is associated with a shortened length of the support member. The support member according to yet another embodiment has a first and a second activated shape.

Abstract: A mitral cerclage annuloplasty apparatus comprises a tissue protective device and a knot delivery device. The tissue protective device comprises a first protective tube and a second protective tube. The knot delivery device comprises a tube wherein a loose knot is looped around its distal end through a hole and wherein tight knot is formed when the distal end of the tube is cut open. Alternatively, the knot delivery device comprises an inner tube and outer tube. The inner tube is insertable and rotatable inside the outer tube. When the tubes are in a closed position by rotating either the outer tube or the inner tube, a hole is created near its distal end. When the tubes are in open position by rotating either the outer tube or the inner tube, the hole joins the opening of the outer tube and lengthens.

Abstract: Disclosed herein are prosthetic devices and related methods for implantation at the native mitral valve of the heart by drawing an atrial portion and a ventricular portion toward each other from opposite sides of the native mitral valve, clamping the native mitral valve therebetween. One or more retention members passing through the mitral valve orifice or through a puncture in the native valve anatomy can couple the atrial and ventricular members together and keep them anchored onto the native mitral valve anatomy. The atrial portion can seat against the atrial side of the mitral annulus while the ventricular portion can include hooks and/or a sub-annular ring that engage and capture the native mitral valve apparatus to provide anchorage. The described technology can avoid the need to use sutures to anchor a prosthetic device at the mitral valve region.

Abstract: An implant for implantation around a circumferential tissue structure in a heart, includes a flexible elongated component having a longitudinal axis and a first distal end portion, a second distal end portion and an intermediate portion extending between the first and second distal end portions, and an inner lumen extending longitudinally between the first and second distal end portions and through the intermediate portion; and a locking member for allowing the first distal end portion to be fixedly connected to the second distal end portion so as to provide the elongated component as a closed loop. The first distal end portion is provided with a first distal opening which connects the inner lumen with an outside of the component. The second distal end portion is provided with a second distal opening which connects the inner lumen with the outside of the component.

Abstract: The present invention provides an artificial heart valve annuloplasty ring, including an outer layer (6) and an annular main body (8) integrally formed from multiple ring sections, the outer layer (6) is a fiber fabric layer covered on the outside of the annular main body (8), the annular main body (8) includes a tube with a tube wall that has a slotted structure capable of adjusting the rigidity of the annuloplasty ring. The artificial heart valve annuloplasty ring provided in the present invention has a simple structure, easy-to-adjust rigidity, and does not need to separately design and manufacture a mold for the main body of the annuloplasty ring during manufacturing.

Abstract: Systems and methods treat a heart valve using a magnetically adjustable annuloplasty ring attached to or near a cardiac valve annulus. A changing magnetic field may be used to selectively increase or decrease a circumference of, or otherwise modify the shape of, the implanted annuloplasty ring. The adjustable annuloplasty ring includes a tubular body member, one or more adjustable members, and an internal magnet within the tubular body member. The tubular body member and the one or more adjustable members form a ring shape. The internal magnet is configured to rotate in response to a rotating external magnetic field. The internal magnet is coupled to the one or more adjustable members to change a dimension of the ring shape as the internal magnet rotates. A system for treating a heart valve may include an external adjustment device having one or more external magnets to generate the rotating external magnetic field.

Abstract: A method is provided that includes implanting (a) a venous first tissue anchor in a vein selected from the group of veins consisting of: a superior vena cava and an inferior vena cava, (b) an atrial second tissue anchor at an atrial site selected from the group of sites consisting of: an annulus of a tricuspid valve, and a wall of a right atrium of a heart above the annulus of the tricuspid valve, (c) a venous third tissue anchor in a coronary sinus, and (d) one or more tethers, which connect the venous first tissue anchor, the atrial second tissue anchor, and the venous third tissue anchor. A size of a tricuspid orifice is reduced by tensioning the one or more tethers. Other embodiments are also described.

Abstract: A device is in various embodiments configured to repair a native heart valve or to secure a prosthetic heart valve within a native valve of the heart of a patient. Embodiments of the device include at least an upper coil and a lower coil, where the device is configured to assume an axially expanded state where the entire upper coil is positioned on a first side of the lower coil relative to the central axis, and an axially compressed state where at least a portion of the upper coil is positioned on a second side of at least a portion of the lower coil opposite to the first side relative to the central axis.

Abstract: A method is provided that includes implanting (a) a first venous tissue anchor in a superior vena cava, an inferior vena cava, or a coronary sinus, (b) exactly two atrial tissue anchors, which consist of second and third atrial tissue anchors, at respective different atrial sites, each of which sites is selected from: an annulus of a tricuspid valve, and a wall of a right atrium of a heart above the annulus, and (c) a pulley system, which includes (i) a pulley, which is connected to the second atrial tissue anchor, and (ii) a tether, which (A) is connected to the first venous tissue anchor and the third atrial tissue anchor, (B) is moveable through the pulley, and (C) has a length, measured between the first venous and the third atrial tissue anchors, of at least 30 mm. A size of a tricuspid orifice is reduced by tensioning the tether.

Abstract: The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices and methods of identifying a suitable location on the tricuspid annulus, placing a wire across the tricuspid annulus at such an identified location, deploying a tissue anchor across such an identified location, deploying two or more tissue anchors and coupling the tissue anchors with a flexible tensioning member, and applying tension to a flexible tensioning member that is coupled with the two or more tissue anchors, plicating tissues between each pair of the two or more tissue anchors, and reducing the circumference of the tricuspid annuls. As a result, a regurgitation jet is reduced or eliminated.

Abstract: Devices and methods are described for treating a mitral valve defect. The device described includes features that allow the device to conform to the actual pathology of the valve, rather than attempting to replicate a healthy valve (which the patient does not have). In this way, the device allows the patient's actual value to work as well as possible, given the valve's diseased condition. The actual pathology of the valve is accommodated by providing for multiple dimensions of adjustability of the device, including adjustability of the size (e.g., diameter) of the device as well as adjustability of the elevation or inclination of one portion of the device (e.g., the portion supporting the posterior leaflet) with respect to another portion of the device.

Abstract: Disclosed here are devices and methods for treating functional tricuspid valve regurgitation and related conditions. Disclosed devices are adapted for applying force to an area of a patient's heart along or near the atrioventricular groove, and can include a tensioning element configured to be delivered by a flexible member guided through a catheter and positioned generally along or near the atrioventricular groove, and a compression member positionable along the tensioning element and over a desired segment of the atrioventricular groove to develop force to be applied to an adjacent area of the heart by selective tensioning of the tensioning element.

Abstract: The device is intended to be positioned in a sealed introducer arranged in the thoracic cavity between two ribs in order to penetrate into the left ventricle, passing through the apex of the heart. According to the invention, the device includes a body having a handle and at least one control member capable of acting on an assembly for installing and securing a braid to the mitral annulus by means of suturing elements, the assembly has a mechanism capable of enabling the extraction of a suture through the mitral valve while also being capable of enclosing the braid and becoming anchored to the periphery of the mitral annulus under the clamping effect of the suture, exerting two opposing pressure-bearing forces.

Abstract: One embodiment is directed to a system for closing a wound created across a portion of a tissue structure, comprising a suture member having proximal and distal ends; an anchor member coupled to the distal end of the suture member; a tension retainer assembly releasably coupleable to the suture member; and a suture buttress movably intercoupled to the suture member between the anchor member and the tension retainer and configured to minimize direct sliding contact between the suture member and the tissue structure portion around the location of the suture buttress.

Abstract: Apparatus includes an annuloplasty structure, including: (i) a tubular body portion that is configured to be disposed at an annulus of a valve of a heart, and is shaped to define a perimeter; (ii) a flexible member, disposed within the tubular body portion; (iii) a first adjustment mechanism, attached to the tubular body portion and to the flexible member such that reversible actuation of the first adjustment mechanism reversibly adjusts a first dimension of the body portion by adjusting tension of the flexible member; (iv) a second adjustment mechanism, coupled to the tubular body portion, and reversibly actuatable to reversibly adjust a second dimension of the body portion. The apparatus further includes one or more elongate tools, reversibly couplable to the first and second adjustment mechanisms, and configured to independently actuate the first and second adjustment mechanisms by applying force thereto while the heart is beating.

Abstract: A method and apparatus for securing soft tissue to bone can include forming a bore in the bone and carrying a flexible suture anchor into the bore. The flexible anchor can include a passage and can be coupled to a suture construct. The suture construct can include at least one self-locking adjustable loop, and the flexible anchor can include a first profile while being carried into the bore. A shape of the flexible anchor can be changed from the first profile to a second profile forming an anchoring mass to retain the flexible anchor in the bore. Tension can be applied to a portion of the suture construct to reduce a size of the self-locking adjustable loop and secure the soft tissue relative to the flexible anchor and the bone.

Abstract: An epicardial clip for reshaping the annulus of the mitral valve of a heart. The epicardial clip includes a curved member having an anterior segment configured to be positioned in the transverse sinus of the heart, a posterior segment configured to be positioned on the posterior side of the heart, such as on or inferior to the atrioventricular groove, and a lateral segment extending between the anterior segment and the posterior segment. The lateral segment includes a curve such that the first end of the member is positioned at or above the plane of the mitral valve and the second end of the member is positioned at or below the plane of the mitral valve.