Systems, devices, and methods for providing access to the heart. The system includes an intracardiac access device comprising an elongate member having a channel extending between a distal end and a proximal end thereof. The intracardiac access device is configured to be advanced through an extrapericardial penetration in the left atrial wall without penetrating the pericardium of the heart. An optional procedural device is configured to be advanced through the channel of the intracardiac access device into an internal chamber of the heart and configured to perform a surgical procedure in the internal chamber of the heart. A working channel of an optional suprasternal access device is configured to facilitate access of the intracardiac access device into the body of the patient by providing a path from a suprasternal opening to a position adjacent the roof of the left atrium.

A prosthetic device for sealing a native heart valves to prevent or reduce regurgitation comprises a spacer having one or more anchors. The spacer may also have atrial support structures, ventricular support structures, or both atrial and ventricular support structures In some cases, the spacer has anchors that attach to the leaflets as well as atrial and ventricular support. In some cases, the spacer straddles the annulus and is located by anchors, and in some cases the support structures can be implanted within the native heart valve. In some cases, the prosthetic device reduces the annulus diameter when implanted within the native heart vasculature. In some cases, the prosthetic device cinches the annulus when implanted within the native heart vasculature.

An anchor for implantation in body tissue has a number of hooks for engagement with the body tissue. The anchor is made of an elastic material such that it can be elastically deformed into a folded position by application of a constraining force, and will return to an unfolded position when no constraining force is applied. A plugging device is combined with one or more parts of the anchor to provide enhanced contact with the body tissue. The plugging device encircles at least one of the hooks. The anchor may be combined with a line which is a part of the plugging device. The line is optionally joined to the anchor by a knotting configuration having a plurality of loops around the anchor. At least one loop of the plurality of loops encircles at least two of the hooks.

A system for annuloplasty is disclosed comprising an annuloplasty device comprising first and second support rings having a coiled configuration in which the first and second support rings are arranged as a coil around a central axis, wherein the first and second support rings are configured to be arranged on opposite sides of native heart valve leaflets of a heart valve, a line attached to the first and/or second support ring, and a heating element configured to be heated upon receiving a supply of energy, wherein the heating element is positionable to heat and sever the line upon the heating element receiving said energy.

A method comprises inserting a needle into a ventricle of a heart. The needle is configured to deliver a first anchoring element, a second anchoring element, and a tethering suture to the ventricle. The tethering suture is tethered between the first anchoring element and the second anchoring element. The method further comprises penetrating a first leaflet of a heart valve with the needle, penetrating a second leaflet of the heart valve with the needle, deploying the first anchoring element at a distal side of the second leaflet, retracting the needle from the first leaflet and the second leaflet, deploying the second anchoring element at a proximal side of the first leaflet, cinching the tethering suture to cause a desired amount of valve coaptation, and locking the tethering suture.

An implant includes a clip and a clip-controller interface. The clip is disposed laterally from a central longitudinal axis of the implant, includes first and second arms articulatably coupled to each other, and sandwiches a leaflet of a heart valve between the first and second arms by articulation between the first and second arms, such that the second arm is disposed laterally from the first arm. The clip-controller interface is reversibly coupled to a clip controller of a delivery tool, and includes first and second portions. The first portion is linearly slidable by the clip controller. The second portion is articulatably coupled to the first portion and to the second arm, such that linear sliding of the first portion causes the second portion to (i) articulate with respect to the first portion, and (ii) push the second arm to articulate toward the axis. Other embodiments are also described.

A sutureless implant for replacing damaged natural chordae tendineae of a human or possibly animal heart, the implant including a distal implant part, a proximal implant part, and an artificial chord. The distal implant part is configured to fit in a lumen of an implant delivery device and includes a self-spreading portion spreading radially outside when the distal implant part is released from the lumen, the self-spreading portion being capable of anchoring the distal implant part in human muscle tissue. The proximal implant part is configured to fit in the lumen of the implant delivery device and comprises a self-spreading portion spreading radially outside when the proximal implant part is released from the lumen, the self-spreading portion being capable of bearing on a tissue portion of leaflet tissue. The distal implant part and the proximal implant part are connected by the chord.

A delivery apparatus for implanting a prosthetic heart valve includes one or more shafts and a handle coupled to the one or more shafts. The handle comprises one or more knobs, one or more adjustment mechanisms, and/or one or more control mechanisms. The knobs are configured for actuating the one or more adjustment mechanisms and/or the one or more control mechanisms. The one or more adjustment mechanisms are configured for moving the shafts relative to each other and/or relative to the handle. The one or more control mechanisms are configured for limiting the direction of movement and/or force applied to the one or more shafts.

A forward-pushing for releasing suture locking device configured to fix a suture in a locking pin includes a collet and a thrust rod assembly sleeved outside the collet. The thrust rod assembly includes a thrust rod. A recessed portion is arranged at the thrust rod, and a protruding portion corresponding to the recessed portion is arranged at the collet. In a process that the thrust rod continuously moves distally in an axial direction, the thrust rod first pushes against a gradually raised side of the protruded portion, so as to allow the collet to deform to compress the locking pin, and allow the locking pin compressed by the collet to deform and fix the suture; and then the protruding portion is gradually accommodated in the recessed portion, so that at least part of deformations of the collet is restored to release the locking pin.

The present disclosure relates to a sheath that is usable with a medical device, particularly to a sheath that is useable with a medical device and which sheath is expandable in the regions that the medical device is positioned in the sheath, and more particularly to a sheath that is useable with a medical device and which sheath is expandable in the regions that the medical device is positioned in the sheath and which sheath reforms to its same or similar size and shape after the medical device has passed through a portion of all of the sheath. The sheath is used to protect the body passageway of a patient as a medical device is inserted into and/or through the body passageway and to a treatment site.