Apparatus is provided that includes first and second tissue-engaging elements, and first and second flexible longitudinal members, coupled at respective first end portions thereof to the first and the second tissue-engaging elements, respectively. The apparatus further includes a first flexible-longitudinal-member-coupling element coupled to a second end portion of the first flexible longitudinal member, a second flexible-longitudinal-member-coupling element coupled to a second end portion of the second flexible longitudinal member, and a flexible longitudinal guide member reversibly coupled to the first flexible-longitudinal-member-coupling element. The first and second flexible-longitudinal-member-coupling elements are configured to be couplable together to couple together the first and the second flexible longitudinal elements. Other applications are also described.

A mitral valve prosthesis to be implanted in a heart, comprises an asymmetrical ring, the asymmetrical ring is dimensioned to mimic a native mitral annulus of a patient; an anterior flexible leaflet and a posterior flexible leaflet, said leaflets suspended from the asymmetrical ring and configured to substantially coapt with each other; and at least four sets of cords, each set of cords attached to the anterior or posterior leaflet on a first end and attached into a cap on a second end, the cap is configured to be attached onto papillary muscles of the heart on another end of the cap.

Methods and systems for improving the competency of a venous valve wherein one or more compressor(s) (e.g., space occupying material(s) or implantable device(s)) is/are delivered to one or more location(s) adjacent to a venous valve to compress the venous valve in a manner that causes one or both leaflets of the valve to move toward the other, thereby improving closure or coaptation of the valve leaflets. The compressor(s) may be delivered by an open surgical approach, by a direct percutaneous approach or by a transluminal catheter-based approach.

Systems for mitral valve repair are disclosed where one or more mitral valve interventional devices may be advanced intravascularly into the heart of a patient and deployed upon or along the mitral valve to stabilize the valve leaflets. The interventional device may also facilitate the placement or anchoring of a prosthetic mitral valve implant. The interventional device may generally comprise a distal set of arms pivotably and/or rotating coupled to a proximal set of arms which are also pivotably and/or rotating coupled. The distal set of arms may be advanced past the catheter opening to a subannular position (e.g., below the mitral valve) and reconfigured from a low-profile delivery configuration to a deployed securement configuration. The proximal arm members may then be deployed such that the distal and proximal arm members may grip the leaflets between the two sets of arms to stabilize the leaflets.

A prosthetic heart valve may include a stent having an inflow end, an outflow end, a collapsed condition, and an expanded condition. The prosthetic valve may also include a collapsible and expandable valve assembly disposed within the stent and having a plurality of leaflets. The prosthetic valve and/or stent may include features to anchor the prosthetic valve to a native valve annulus and to seal the prosthetic valve with respect to the native valve annulus, such as planar and/or nonplanar annular sealing members coupled to ends of the stent. The stent may include one or more circumferential rows of anchor members or hooks extending radially outwardly from the stent. These hooks may be configured to extend in a particular direction when the stent is in the collapsed condition to facilitate resheathing of the stent if, upon deployment, a user determines the prosthetic heart valve is not positioned optimally.

The present disclosure provides aortic valve prosthetic devices that are constructed in a non-axisymmetric shape, or are expandable to a non-axisymmetric shape for improved results in the repair of defective aortic valves. The devices can be surgically implanted, or they can be implanted percutaneously through an insertion catheter. The expandable devices can be self-expanding or expanded by an inflatable balloon to a non-axisymmetric cross-section geometry.

An annuloplasty implant is disclosed comprising first and second supports being adapted to be arranged as a coil in a coiled configuration around an axial direction. The first and second supports are adapted to be arranged on opposite sides of native heart valve leaflets. The first support comprises first retention units fixed in relation to an outer surface of the first support and arranged along at least a first retention portion thereof. The second support comprises second retention units fixed in relation to an outer surface of the second support and arranged along at least a second retention portion thereof. First and second retention portions are curved in the coiled configuration, and the first and second retention units extend from respective first and second retention portions to produce a retention force, in use, at both of said opposite sides. A method of repairing a defective heart valve is also disclosed.

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.

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.