Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post-deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture. A visualization system can be used to provide visual feedback with respect to approximating the targeted tissue and the locking sutures.

Several heart wall remodeling devices and methods are disclosed. One heart wall remodeling device includes a trimming tool for trimming a line within a patient. The trimming tool includes an actuator for manipulation by a user, a moveable inner shaft coupled to the actuator, and an outer sleeve coupled to the inner shaft. The outer shaft includes a backstop disposed along an inner wall of the outer sleeve and a channel disposed between a first end and a second end of the outer sleeve. The inner shaft includes an inner shaft, a compressible member, and a cutter.

A method is provided including inserting into a heart a tissue-adjusting member selected from the group consisting of: one or more artificial chordae tendineae and an annuloplasty ring structure. An adjusting mechanism of the tissue-adjusting member adjusts tension of the tissue-adjusting member. The adjusting mechanism: (a) includes a locking mechanism configured to restrict adjusting of the tissue-adjusting member by the adjusting mechanism, and (b) is shaped to define a first coupling. The method further includes, using a tool reversibly coupled to the adjusting mechanism, restricting the adjusting of the tissue-adjusting member by the adjusting mechanism, by facilitating movement of the locking mechanism into a locked state. The tool is shaped to define a second coupling that mates with the first coupling of the adjusting mechanism. The first and second couplings are coupled together and remain mated during the restricting of the adjusting of the tissue-adjusting member.

A method is provided, including implanting at least a first tissue-engaging element (60a) in a first portion of tissue in a vicinity of a heart valve (4) of a patient, implanting at least a second tissue-engaging element (60b) in a portion of a blood vessel (8, 10) that is in contact with an atrium (6) of a heart (2) of the patient, and drawing at least a first leaflet of the valve (4) toward at least a second leaflet of the valve (4) by adjusting a distance between the portion of the blood vessel (8, 10) and the first portion of tissue in the vicinity of the heart valve (4) of the patient. Other applications are also described.

Devices, systems, and methods for treating a heart of a patient may make use of one or more implant structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart.

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.

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 applications in which it is desired to repair a heart valve.

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.

Suturing devices and systems used to close openings into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more arms, and one or more needles. One or more sheaths may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

A method is provided of reducing tricuspid valve regurgitation of a patient. A first tissue anchor is implanted at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient. A second tissue anchor is implanted at a second implantation site of the patient, different from the first implantation site. After the first and the second tissue anchors have been implanted, a longitudinal member that couples the first and the second tissue anchors together is longitudinally deflected.