A mitral cerclage annuloplasty apparatus comprises a tissue protective device and a knot delivery device. The tissue protective device comprises a first protective tube and a second protective tube. The knot delivery device comprises a tube wherein a loose knot is looped around its distal end through a hole and wherein tight knot is formed when the distal end of the tube is cut open. Alternatively, the knot delivery device comprises an inner tube and outer tube. The inner tube is insertable and rotatable inside the outer tube. When the tubes are in a closed position by rotating either the outer tube or the inner tube, a hole is created near its distal end. When the tubes are in open position by rotating either the outer tube or the inner tube, the hole joins the opening of the outer tube and lengthens.

Described herein are devices and methods for mitral valve repair. The devices and methods implant a plurality of distal anchors at an annulus of the mitral valve (e.g., the posterior annulus) and tension artificial chordae to pull the portion of the annulus toward an opposite edge and inward into the ventricle. This can effectively reduce the size of the orifice and increase coaptation. The delivery devices can be configured to be actuated to form a distal anchor made of a pre-formed knot. The delivery devices deliver the pre-formed knot in an elongate configuration. Actuation of the delivery device causes the pre-formed knot to transition from the elongate configuration to the deployed configuration by approximating opposite ends of a suture coupled to a coiled configuration to form one or more loops. After formation of the knot, the delivery device can be withdrawn.

Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. A protective device can be placed between the annuloplasty device and an underlying coronary artery to inhibit compression of the underlying coronary artery by the annuloplasty device in the coronary sinus. In addition, the protective device can inhibit compression of the coronary artery from inside the heart, such as from a prosthetic mitral valve that exerts radially outward pressure toward the coronary artery. The annuloplasty device can also create an artificial inner ridge or retaining feature projecting into the native mitral valve region to help secure a prosthetic mitral valve.

A device for adjusting a shape of a coronary sinus in a heart of a patient, the device comprising a flexible tube having: an outer wall extending between a proximal end and a distal end; a first bore extending from the proximal end to the distal end; a proximal flange attached to the proximal end; a distal flange attached to the distal end; wherein, the outer wall includes at least one accordion-like hinge region.

The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices each includes a vascular anchor, an annulus anchor, and at least one tensioning member connecting with the vascular anchor or the annulus anchor. Another aspect of the present teachings provides methods of deploying a vascular anchor at a first treatment location inside the coronary sinus, and deploying an annulus anchor at a second treatment location across the tricuspid annulus. When both the anchors are pulled towards each other, the portion of the annulus between the two anchors is plicated, which improves the coaptation of the tricuspid valve leaflets.

A heart valve therapeutic device (1) has an elongate anchor (7) wherein the anchor has a stiffness to hold its shape and location to support the valve element. The anchor may have a stylet or a shaped or stiff collar (70) arranged to provide a desired shape to the anchor (7) and it may be lockable. A prosthetic valve element (15) has leaflets (17) and is supported on the anchor by coupler (16, 50) at a desired location. There is an actuator for changing relative axial position of the proximal and distal couplers (16, 50) on the anchor. The anchor stiffness may be sufficient to provide sufficient support to resist axial forces from the ventricle in use without necessarily having a fixing element engaging heart tissue. The prosthetic leaflets (240) may extend proximally and radially outwardly, so that there is excellent co-apting of the native leaflets (NL) against the prosthetic leaflets (240).

The present invention relates to a cerclage atrial defibrillator, and more particularly, is for treating mitral valve regurgitation and atrial fibrillation by reducing the size of the left atrium through a cerclage wire and treating residual atrial fibrillation by including a defibrillator lead. In order to achieve the above objective of the present invention, the cerclage atrial defibrillator includes: a cerclage wire; a coronary sinus tube provided with a lumen formed therein into which the cerclage wire is inserted, the coronary sinus tube being inserted into the coronary sinus; a tricuspid valve tube provided with a lumen formed therein, the tricuspid valve tube traversing the tricuspid valve and protecting the tricuspid valve and tissue of the interventricular septum; a pacemaker lead having an end thereof inserted into the bundle of His; and a defibrillator lead inserted into the coronary sinus tube to treat atrial fibrillation.

The present invention relates to a tissue protection device for mitral valve cerclage annuloplasty and, more particularly to a tissue protection device for protecting tissues of the body (heart) during mitral valve cerclage annuloplasty that is performed on a mitral valve cerclage patient with mitral regurgitation. The tissue protection device for mitral valve cerclage annuloplasty of the present invention is a hollow cylindrical tube where cerclage sutures (10a, 10b) are inserted, in which a hole (22) is formed at a predetermined portion of the cylindrical tube so that a coronary sinus cerclage suture (10a) inserted in a coronary sinus comes out of the cylindrical tube, and a lower section from the hole is inserted into the tricuspid valve to protect tissues of the tricuspid valve and the ventricular septum.

A method of treating a heart of a patient is provided. The method includes implanting a first tissue anchor in cardiac tissue of the patient and a second tissue anchor in the patient, such that the first and the second tissue anchors are coupled together by one or more tethers. Thereafter, after allowing at least 24 hours for tissue growth on the first tissue anchor to strengthen anchoring of the first tissue anchor in the cardiac tissue, tension is applied between the first and the second tissue anchors using at least a longitudinal portion of the one or more tethers. Other embodiments are also described.

An implantable medical device is disclosed including an anchor unit configured to be permanently anchored at a cardiac valve of a patient, at least one locking unit, such as for fixation of tissue of the cardiac valve and/or fixation of at least a part of a shape of the anchor unit, and at least one coupling unit for connecting the anchor unit to at least one of the locking unit. The coupling unit has a first end portion and a second end portion, wherein the first end portion is connectable to the anchor unit, and the second end portion includes the locking unit.