A method is described, for use with a native valve of a heart of a subject, the valve being disposed between an atrium and a ventricle of the heart. A first radiopaque marker and a second radiopaque marker are percutaneously advanced to the heart. The first radiopaque marker is placed against a tissue site in the ventricle. The second radiopaque marker is placed against a leaflet of the valve. A distance is measured between the first radiopaque marker at the tissue site, and the second radiopaque marker at the leaflet. Responsively to the measured distance, a chord-length is determined. An artificial chord, selected based on the chord-length, is implanted in the heart. Other embodiments are also described.

To provide a valve cusp sizer which is small and easy to handle. The present invention relates to a valve cusp sizer 100 for determining the size of a valve cusp depending on the size of a cardiac valve. The valve cusp sizer 100 includes a front surface 10 formed in an arcuate surface form to be abutted against an organism, a back surface 20 positioned on an opposite surface side of the front surface 10, and a pinching portion 30 protruding from the back surface 20. By removing a grip member and a grip member attachment portion from a conventional valve cusp sizer in this manner, and by forming the pinching portion 30 to be held by a clamp, tweezers, or the like, it is possible to dramatically miniaturize the valve cusp sizer while maintaining necessary functions of the valve cusp sizer.

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.

A sizing device for a collapsible prosthetic heart valve, the sizing device includes a collapsible and expandable balloon having a proximal end, a distal end. At least one microelectromechanical sensor is coupled to the balloon, the at least one sensor being capable of measuring information related to size and stiffness of tissue.

A heart size measuring tool includes a tubular body, a flexible measuring cord having length indicia, a measuring cord support mechanism movable between retracted and extended states with respect to the body, and an actuating mechanism to move the measuring cord support mechanism. When in the retracted state the measuring cord support mechanism is positioned within the tubular body with the measuring cord in a collapsed position. When the measuring cord support mechanism is in the extended state the measuring cord extends around a portion of a heart to be measured. A scale on the body can be used in connection with the indicia on the measurement cord to provide a reading of the heart size.

An adjustment tool enables manipulation of a prosthetic anatomical device such as an annuloplasty ring. The tool includes a compression member which is operative for retarding rotation of the adjustment shaft to preclude inadvertent rotation thereof during use of the tool by the surgeon. A locking device is associated with the adjustment tool to enable the releasable attachment of the tool to the anatomical device during its adjustment by manipulation of the tool. The locking device is oriented into operative and inoperative positions by the engagement and disengagement of locking elements. A scale may be provided on the adjustment tool to assist a surgeon in determining the size or amount of adjustment to the size of the anatomical device during its adjustment.

A prosthetic heart valve reinforcement ring is disclosed. The prosthetic includes an outer ring sized and dimensioned to fit around an annulus of a heart valve and an inner ring configured and arranged to couple to the outer ring. The inner ring and the outer ring have complimentary mating formations configured and arranged to grip sutures therebetween. A method of reinforcing heart valve is also disclosed. Sutures are provided around an annulus of a heart valve. The sutures are corralled within an outer sizing ring. The outer sizing ring is placed around the annulus of the heart valve. An inner sizing ring is inserted within the outer ring, locking the sutures. The sutures are adjusted and the heart valve is tested for a proper fit. The outer sizing ring is removed and a prosthetic ring is placed over the inner sizing ring, locking the sutures. The sutures are tied.

Devices and methods are provided for surgical repair of dilated aortic root to restore aortic valve competence while preserving native leaflets. In one aspect of the invention an expandable annuloplasty ring is provided for external placement at the base of a dilated aortic root. The expandable ring is capable of elastically expanding between a first diastolic diameter and a larger second systolic diameter to provide a physiologically representative surgical repair of the aortic root. In a further aspect of the invention, is provided a holder assembly for aortic annuloplasty ring and suitable for other cardiac valve prosthesis. The holder assembly consists of a holder body pivotingly coupled to a handle member through a ball-and-socket arrangement.

Provided is a template 1 including a plurality of forming parts 2 to accommodate various sizes of valve cusps to be formed from a pericardium. Each of the forming parts 2 includes a hole 10A and a hole 10B for drawing lines which indicate positions at which the pericardium taker from a patient is to be cut. Each of the forming parts 2 further includes a hole 11A, a plurality of holes 11B, holes 11C, and holes 11D for drawing marks that indicate positions at which a valve cusp material cut and formed from the pericardium is sutured to a blood vessel. The lines that indicate the cutting positions are drawn on the pericardium by moving a skin marker 5 along the holes 10A and 10B. The drawing of the marks corresponding to the suture positions at the hole 11A, the holes 11B, the holes 11C, and the holes 11D is carried out with the skin marker 5.

A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.