A tissue anchor is provided that includes a head connected to a shaft, and a tissue-coupling element extending from the shaft. When the tissue anchor is unconstrained, the head is coaxial with an axis of the shaft, and the tissue-coupling element is generally orthogonal to the axis and is shaped such that if the tissue-coupling element were to be projected onto a plane that is perpendicular to the axis, (a) at least 80% of an area of a projection of the tissue-coupling element on the plane would fall within a first angle of 180 degrees in the plane having a vertex at the axis, and (b) the area would partially overlap, at least 3 mm from the vertex, both rays of a second angle of between 45 and 180 degrees in the plane having the vertex at the axis. Other embodiments are also described.

The present invention provides methods and devices for grasping, and optional repositioning and fixation of the valve leaflets to treat cardiac valve regurgitation, particularly mitral valve regurgitation. Such grasping will typically be atraumatic providing a number of benefits. For example, atraumatic grasping may allow repositioning of the devices relative to the leaflets and repositioning of the leaflets themselves without damage to the leaflets. However, in some cases it may be necessary or desired to include grasping which pierces or otherwise permanently affects the leaflets. In some of these cases, the grasping step includes fixation.

A tissue anchor (20) comprises a helical tissue-coupling element (30) disposed about a longitudinal axis (32) thereof and having a distal tissue-penetrating tip (34). The helical tissue-coupling element (30) has: a first axial stiffness along a first axial portion (60) of the helical tissue-coupling element (30); a second axial stiffness along a second axial portion (62) of the helical tissue-coupling element (30) more distal than the first axial portion (60), which second axial stiffness is greater than the first axial stiffness; and a third axial stiffness along a third axial portion (64) more distal than the second axial portion (62), which third axial stiffness is less than the second axial stiffness. Other embodiments are also described.

Apparatus includes a tube and an implant moveable at least in part through a lumen of the tube. The implant includes a longitudinal member and a locking mechanism coupled to the longitudinal member. The locking mechanism has (i) an unlocked state in which the locking mechanism is configured to facilitate adjustment of tension of the longitudinal member, and (ii) a locked state in which the locking mechanism is configured to restrict adjustment of the tension of the longitudinal member. A tool maintains the locking mechanism in the unlocked state via contact of the tool with the locking mechanism in the heart, and moves the locking mechanism into the locked state. The locking mechanism is disposed distally to the distal end of the tube while the longitudinal member is disposed entirely within the tube. Other applications are also described.

The invention relates to a device for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation enhancement element for implantation across the valve; a system including the coaptation enhancement element and anchors for implantation; a system including the coaptation enhancement element, catheter and driver; and a method for transcatheter implantation of a coaptation element across a heart valve.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium, through the mitral valve, and into the left ventricle. A ventricular anchor is deployed from the catheter and into a wall of the left ventricle, leaving a ventricular suture attached to the ventricular anchor and extending proximally through the catheter. A leaflet anchor is deployed to secure a mitral valve leaflet to a leaflet suture, with the leaflet suture extending proximally through the catheter. The leaflet suture is secured to the ventricular suture to limit a range of travel of the leaflet in the direction of the left atrium. Also disclosed is an assembled in situ mitral valve leaflet restraint, having a neo papillary muscle and a neo chordae tendinea.

Veins and other blood vessels may be reshaped by introducing an implant through the vessel walls with anchors positioned on opposite sides of the wall. The anchors typically include an elongate body having coils or other anchors formed therein. The implants may be delivered percutaneously using a cannula which can hold the anchor externally or internally. The methods and devices are useful in treating a dorsal vein to reduce blood flow in patients suffering from erectile dysfunction.

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.

Apparatus for repairing a heart valve and methods for implanting anchors and repairing a heart valve are provided. The apparatus comprises a body, a member attached to the body at a first end and having a plurality of positioning cords spaced laterally across the member and extending away from a second end of the member opposed to the first end, a tube suspended from the plurality of positioning cords, and an adjustment cord extending through the tube. The method comprises implanting at least one annular anchor in a mitral annulus of the heart valve, implanting a papillary anchor through each papillary muscle of the heart, delivering and positioning an apparatus for repairing a heart valve inside the heart valve using the at least one annular anchor and the papillary anchors, and adjusting the apparatus to adjust the extent of atrial displacement of the heart's mitral leaflets during ventricular contraction.

A deployment system includes a sheath, a torque able shaft having a handle positioned at its proximal end, a detachable helical first suture anchor positioned at the shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The shaft is detached from the first suture anchor thereby deploying it at the first tissue location. Then, the deployment system is removed from the patient, and a second suture anchor is coupled to the distal end of the shaft. The deployment system is re-inserted into the patient and the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second suture anchor at the second tissue location. A suture extends between the first and second fasteners, and tension is applied to the suture to draw the first and second tissues toward each other to reconfigure the tissue.