An apparatus for implantation at an annulus (75) of an intracardiac valve includes an annuloplasty ring (110) comprising a plurality of rotatably adjoining segments (112). The ring is configured to pass over multiple threads (58), respective distal ends of which are distributed over the annulus, and, while passing over the threads, expand from a collapsed state to an expanded state by virtue of the segments rotating with respect to each other. The apparatus further comprises a lock (114), configured to lock the ring in the expanded state at the valve by inhibiting rotation of the segments with respect to each another. Other embodiments are also described.

The invention generally relates to co-axial stent and catheter systems and medical procedures utilizing these systems. The co-axial stent system is characterized by two-coaxial stents, including an outer resorbable stent and an inner metal stent used to effect deployment of the resorbable stent. The stents may use for treatment of unstable plaque and/or thrombus at the carotid bifurcation and particularly those that are not causing any significant stenosis. The stents may also be used for treatment of cerebral aneurysms. The invention further describes related, equipment, uses and kits for the treatment of unstable plaque and/or thrombus and/or aneurysms.

A dissection prosthesis system for implantation within a blood vessel includes a first prosthesis and a second prosthesis. The first prosthesis includes a first stent ring, a second stent ring, a first graft material band coupling the first stent ring to the second stent ring, a third stent ring, and a second graft material band coupling the second stent ring to the third stent ring. The second stent ring includes a plurality of openings that enable fluid flow from a lumen of the first prosthesis through the plurality of openings. The graft material bands may include band openings disposed therethrough to enable fluid flow from the lumen through the band openings. The second prosthesis includes a stent coupled to a graft material. The second prosthesis is configured to be disposed within the lumen of the first prosthesis.

A prosthetic heart valve for functionally replacing a previously implanted prosthetic heart valve is disclosed. The prosthetic heart valve includes a collapsible support structure with leaflets and anchors mounted to the support structure. The support structure also includes an inflow end and an outflow end. The anchors include a radially outwardly extending first anchor proximate to the inflow end and a radially outwardly extending second anchor proximate to the outflow end. The first anchor includes a first configuration and the second anchor includes a second configuration where the first configuration is different than the second configuration. The previously implanted prosthetic heart valve serves as a platform for securement of the prosthetic heart valve to the patient's native tissue.

An iliac branch device includes an iliac septum limb configured to be deployed in the common iliac artery. The iliac septum limb includes a graft material, a proximal end, and a septum. The graft material defines a common iliac lumen extending between the proximal end and the septum, the graft material and the septum defining an internal iliac lumen and an external iliac lumen. The iliac branch device including the iliac septum limb has several modes of adjustability. In addition, the iliac branch device has a relatively small cross-sectional area allowing the iliac branch device to treat relatively small iliac aneurysms in short common iliac arteries. This allows the iliac aneurysms to be treated at very early stages of the disease.

In some embodiments, a method includes delivering to a native valve annulus (e.g., a native mitral valve annulus) of a heart a prosthetic heart valve having a body expandable from a collapsed, delivery configuration to an expanded, deployed configuration. The method can further include, after the delivering, causing the prosthetic heart valve to move from the delivery configuration to the deployed configuration. With the prosthetic heart valve in its deployed configuration, an anchor can be delivered and secured to at least one of a fibrous trigone of the heart or an anterior native leaflet of the native valve. With the prosthetic heart valve disposed in the native valve annulus and in its deployed configuration, an anchoring tether can extending from the anchor can be secured to a wall of the heart to urge the anterior native leaflet towards the body of the prosthetic heart valve.

Pinch devices and access systems that can be used to secure a prosthetic heart valve to a heart valve annulus and to treat valvular insufficiency. A pinch device can be a separate expandable element from the prosthetic heart valve that is first advanced to the annulus and deployed, after which an expandable prosthetic heart valve can be advanced to within the annulus and deployed. The two elements can clamp/pinch the heart valve leaflets to hold the prosthetic heart valve in place. The pinch device can have a flexible, expandable annular frame. A combined delivery system can deliver the pinch device and prosthetic heart valve with just a single access point and aid more accurate coaxial deployment. The pinch device can be mounted near distal end of an access sheath, and a catheter for delivering the prosthetic heart valve can be passed through a lumen of the same access sheath.

Apparatus and methods are described including a prosthetic atrioventricular valve (10) for coupling to a native atrioventricular valve (12). The prosthetic valve includes a support frame (20) and a covering (22), which at least partially covers the support frame. The support frame and the covering are shaped so as to define a downstream skirt (24). A plurality of prosthetic leaflets (40) are coupled to at least one element selected from the group consisting of: the support frame and the covering. An elongated anchoring member (152) is positioned around the downstream skirt in a subvalvular space (150), such that the anchoring member presses native leaflets (30) of the native valve against the downstream skirt, thereby anchoring the prosthetic valve to the native valve. Other applications are also described.

Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatus for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allows adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen-demanding tissues, are not deprived of the necessary blood flow.

A device structured to suppress mitral regurgitation by restricting prolapse of a mitral valve leaflet and including a base correspondingly dimensioned to the mitral valve and including a central portion, structured to allow blood flow there through and a peripheral portion or ring connected to the central portion in substantially surrounding relation thereto. An operative position of the base includes the central portion disposed in overlying, movement restricting relation to at least one of the valve leaflets and the ring concurrently anchored adjacent or directly to the native annulus of the mitral valve. The physical characteristics of the base facilitate its movement with and conformance to the mitral valve during diastole and systole cycles of the heart.