An annuloplasty ring holder including a head having an upper surface and an annuloplasty ring receiving surface facing opposite the upper surface. The annuloplasty ring holder also includes means for attaching an annuloplasty ring to the annuloplasty ring receiving surface. The means for attaching an annuloplasty ring to the annuloplasty ring receiving surface may include one or more suture guides operatively associated with the head and configured to position one or more sutures to removably associate an annuloplasty ring with the annuloplasty ring receiving surface. The head may include a central hub and more than one spoke radiating out from the central hub. If the head is thus configured, each spoke will include a portion of the annuloplasty ring receiving surface.

Apparatus for percutaneous access to a patient's body comprising a first steerable tube (12), shaped to define a first lumen, and a first coupling (152) at a longitudinal site of the first tube; and a second steerable tube (14), shaped to define a second lumen and a second coupling (154), the second coupling being intracorporeally couplable to the first coupling, the apparatus having (A) an unlocked state in which the second tube is rotatable within the first lumen, and (B) a locked state in which the second coupling is coupled to the first coupling, and rotation of the second tube is inhibited. The apparatus is configured such that when the second coupling becomes disposed at the longitudinal site in a given rotational orientation of the second tube, the apparatus moves into the locked state by the second coupling automatically coupling to the first coupling. Other embodiments are also described.

A method and device for anchoring a prosthetic heart valve or annuloplasty ring to a valve annulus in a heart and a method of implanting same is disclosed. The device can include a prosthetic valve or annuloplasty ring with one or more anchors configured to be threaded or otherwise passed underneath a native leaflet and/or subvalvular tissue to secure the device at the native annulus.

A catheter (4) based medical system (1) and medical procedure for reducing cardiac valve regurgitation are disclosed. The system comprises a resilient curvilinear shaped annuloplasty implant (3) for reducing the size of a dilated annulus (18) of said valve for reducing said regurgitation having resilient anchoring elements (300), and a delivery device (2) for said annuloplasty implant (3) having a distal curvilinear shaped portion (200) that is hollow to mount said annuloplasty implant (3) and has an annular opening (201) arranged to be in apposition against an annulus (18) of said cardiac valve. A plurality of suction units allows for a atrial approach and symmetric implantation of said implant.

According to one representative embodiment, a method of treating aortic insufficiency comprises delivering a support structure to a position around the leaflets of a native heart valve. An expandable prosthetic heart valve can be advanced into the native heart valve and into the interior of the annular body. The prosthetic heart valve can be expanded into contact with the leaflets of the native valve, thereby causing the leaflets of the native valve to be frictionally secured between an inner surface of the annular body and an outer surface of the prosthetic heart valve. A delivery apparatus for delivering the support structure can include a first shaft that is allowed to move in a proximal direction relative to a second shaft, when the second shaft foreshortens as a result of an adjustment mechanism being actuated to increase the curvature of the second shaft.

Systems, devices and methods for repairing a native heart valve. In one embodiment, a repair device for repairing a native mitral valve having an anterior leaflet and a posterior leaflet between a left atrium and a left ventricle comprises a support having a contracted configuration and an extended configuration. In the contracted configuration, the support is sized to be inserted under the posterior leaflet between a wall of the left ventricle and chordae tendineae. In the extended configuration, the support is configured to project anteriorly with respect to a posterior wall of the left ventricle by a distance sufficient to position at least a portion of the posterior leaflet toward the anterior leaflet.

The present invention provides an intracardiac device (60) suitable for endovascular and/or transapical implantation at a cardiac valve annulus, wherein said device comprises means for reducing paravalvular leakage (PVL), said means being selected from the group consisting of: lateral-edge extensions, one or more tubular sealing elements, one or more barbs, an inferiorly-directed circumferential fabric skirt (68) attached to the inner circumference of the intracardiac device and an inferiorly-directed fabric curtain attached to the outer circumference of said device.

In certain aspects, the invention relates to a method for generating a mitral repair ring for a corresponding mitral valve, comprising the steps of generating (S1) a reference circumference (13) indicative of said valve ring (110); generating (S2) a reference grid (2); inscribing (S3) said reference circumference (13) in said reference grid (2); combining (S4) said reference circumference (13) with a plurality of characteristic measures (15, 16, 17, r1-r6) of said mitral valve (100); generating (S5) a three-dimensional reference grid (250); identifying (S6) on said three-dimensional reference grid (250) a plurality of deformation points (300-302) of said reference circumference (13); deforming said reference circumference (13) at said deformation points (300-303) so as to obtain a geometric model (10) of said mitral repair ring (10′); and generating said mitral repair ring (10′) from said obtained geometric model (10). The invention also relates to the mitral repair ring obtained by means of the aforesaid method and to its use in mitral annuloplasty.

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascular delivery, and full intra-atrial adjustability and retrievability years after implant. The implants or systems of implants and methods also make use of strong fluoroscopic landmarks. The implants or systems of implants and methods make use of an adjustable implant and a fixed length implant. The implants or systems of implants and methods may also utilise an adjustable bridge stop to secure the implant, and the methods of implantation employ various tools.

The disclosure describes an annuloplasty device that includes a wire configured to extend around at least part of an annulus of a cardiac or vascular valve, such as at least partially around a circumference of the annulus, and a plurality of anchors. The anchors of the plurality of anchors are configured to engage the wire and anchor the wire to the annulus. The wire is configured to urge at least some anchors of the plurality of anchors toward each other in a radially inward direction to decrease a distance between valve leaflets that extend from the annulus.