Medical devices, systems, and methods reduce the distance between two points in tissue, often for treatment of congestive heart failure and often in a minimally invasive manner. An anchor is inserted along an insertion path through a first wall of the heart. An arm of the anchor is deployed and rotationally positioned according to a desired alignment. Application of tension to the anchor may draw the first and second walls of the heart into contact along a desired contour so as to effect a desired change in the geometry of the heart. Additional anchors may be inserted and aligned with the first anchor to close off a portion of a ventricle such that the ventricle is geometrically remodeled and disease progression is reversed, halted, and/or slowed.

A torque-delivering cable is provided, which includes a first coupling. The torque-delivering cable and the first coupling are shaped so as to collectively define a first passage therethrough. A tissue anchor is further provided, which includes a tissue-engaging element and a second coupling, which second coupling is shaped so as to define a second passage therethrough. The first and the second couplings are interlockingly coupleable to each other. An elongate longitudinal locking element is additionally provided, which is shaped so as to define a sharp tip, and which (a) when reversibly disposed in the first and the second passages, maintains coupling together of the first and the second couplings, and (b) when withdrawn from the second passage, allows decoupling of the first and the second coupling from each another

Apparatus is provided, including a tissue-adjusting member selected from the group consisting of: one or more artificial chordae tendineae and at least a portion of an annuloplasty ring structure. The tissue-adjusting member includes an adjusting mechanism that is configured to adjust a tension of the tissue-adjusting member. The adjusting mechanism includes a locking mechanism configured to restrict adjusting of the tissue-adjusting member by the adjusting mechanism. An elongate member is configured to maintain the locking mechanism in an unlocked state during adjusting of the tension of the tissue-adjusting member by the adjusting mechanism, and facilitate locking of the adjusting mechanism by the locking mechanism. A tool is configured to facilitate actuation of the adjusting mechanism to adjust the tension of the tissue-adjusting mechanism. The elongate member and the tool are slidably coupled with respect to each other. Other applications are also described.

Implants, implant systems, and methods for treatment of mitral valve regurgitation and other valve diseases generally include a coaptation assist body which remains within the blood flow path as the leaflets of the valve move, the valve bodies often being relatively thin, elongate (along the blood flow path), and/or conformable structures which extend laterally from commissure to commissure, allowing the native leaflets to engage and seal against the large, opposed surfaces on either side of the valve body during the heart cycle phase when the ventricle contracts to empty that chamber of blood, and allows blood to pass around the valve body so that blood flows from the atrium to the ventricle during the filling phase of the heart cycle. Separate deployment of independent anchors near each of the commissures may facilitate positioning and support of an exemplary triangular valve body, with a third anchor being deployed in the ventricle. An outer surface of the valve body may accommodate tissue ingrowth or endothelialization, while a fluid-absorbing matrix can swell after introduction into the heart. The valve body shape may be selected after an anchor has been deployed, and catheter-based deployment systems may have a desirable low profile.

A system is provided for repairing a cardiac valve of a patient. The system includes a tissue-engaging stent, which is configured to be implanted in a portion of a blood vessel that is in contact with an atrium of a heart of the patient; and a tissue-engaging element, which is configured for implantation at least in part in cardiac tissue at a cardiac implantation site. The system further includes a flexible longitudinal member, which has (a) a first portion that is coupled to the tissue-engaging element, and (b) a second portion that comprises one or more engaging elements, which are configured to be coupled to a strut of the tissue-engaging stent following the implantation of the tissue-engaging element, thereby maintaining tension between the tissue-engaging element and the tissue-engaging stent.

A method is provided for repairing the tricuspid valve of a patient using tension. A radially-expandable stent is implanted in a coronary sinus of the patient. A tissue anchor is implanted in tissue in the vicinity of the tricuspid valve. The tricuspid valve is repaired by applying tension between the radially-expandable stent and the tissue anchor using a flexible longitudinal member that connects the radially-expandable stent and the tissue anchor.

A surgical suturing device is disclosed. The surgical suturing device may include a first or a second tissue gap, a first pair of needles configured to be movable across the first tissue gap, a second pair of needles configured to be movable across the second tissue gap, and a first suture having first and second ends. The surgical suturing device also includes a second suture having first and second ends and a needle actuator which selectively engages either: the first pair of needles to drive them through the first tissue gap and into communication with the first end of the first suture and the first end of the second suture, respectively; or the second pair of needles to drive them through the second tissue gap and into communication with the second end of the first suture and the second end of the second suture.

Tissue anchors include a flat, broad, and large contact surface for engagement with a portion of tissue. Several embodiments of composite tissue anchors include a support element and an overlay element. Tissue anchor assemblies include two or more tissue anchors, a connector, and a cinching mechanism. In some embodiments, the tissue anchors included in the tissue anchor assemblies are of different types, sizes, and/or shapes.

Synthetic chord devices and methods for using the same for connecting tissues are provided. Aspects of the synthetic chord device include a flexible cord having an attachment element at both a first and a second end, wherein each attachment element includes a piercing member coupled to a securing member that attaches the flexible cord to a first tissue. At least a portion of the flexible cord can be configured to be secured to a second tissue. Aspects of the invention also include sets of the synthetic chord device with pre-measured flexible cords. The devices and methods of the invention find use in a variety of applications, such as in is applications in which it is desired to repair a heart valve.

This disclosure includes apparatuses and techniques to access the right ventricle via trans-femoral vein threading a catheter or catheters to the apex or bottom of the right ventricle. Piercing through the venous or right side of the heart in the interventricular septal wall to access the left ventricle a catheter can be passed to turn upward pointing to the mitral valve. From this access point in the left ventricle the flail mitral leaflet can be sutured and tethered pulling it back into position and reattached with a grounding anchor in the right ventricle or imbedding the anchor into the septal wall. The interventricular septal wall crossing technique could include the passing of a coaxial catheter through the first access catheter where the first access catheter could act as a guide to direct the internal or second coaxial catheter toward the flail mitral leaflet.