Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a leaflet suture. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.

In some examples, a delivery device includes a handle that includes a control member, an elongate body, a plurality of arms extending from a distal portion of the elongate body to a distal collar configured to releasably couple to an annuloplasty device. The plurality of arms is operatively coupled to the control member and configured to position the annuloplasty device at a target site in a patient. The delivery device further comprises a plurality of anchors configured to secure the annuloplasty device to tissue at the target site, each respective anchor of the plurality of anchors deployable from a respective arm of the plurality of arms.

A system for treating valvular regurgitation in a heart valve includes a flexible canopy and an elongated tether including an elastic portion and an inelastic portion. When the system is in a deployed configuration, a proximal end of the flexible canopy is coupled to an annulus of the heart valve and a distal end of the elongated tether is coupled to a ventricle. The flexible canopy is configured to overlay a first native leaflet of the heart valve, and tension on the elongated tether is applied and/or adjusted to prevent the first leaflet from prolapsing, to maximize coaptation of the flexible canopy with a second native leaflet of the heart valve, and to minimize regurgitation of the heart valve.

Kit includes coaptation aid and fixation system for repair of leaflets of a heart valve. Coaptation aid includes coaptation catheter having an expandable member at a distal end thereof adapted to be introduced to a left ventricular outflow tract of a heart via a retrograde approach. Expandable member has a delivery configuration with a reduced cross-dimension and a deployed configuration with an expanded cross-dimension adapted to contact a ventricular side of a first leaflet of a heart valve and position the first leaflet generally proximate a coapting configuration with a second leaflet. Fixation system includes a delivery catheter having a distal end, and a fixation device removably coupled to the distal end of the delivery catheter and is adapted to couple the first leaflet to the second leaflet of the heart valve. Methods for fixation of native leaflets of a heart valve using a coaptation aid also disclosed.

An implant catheter has a highly flexible portion. The highly flexible portion includes a liner positioned adjacent to a catheter coil. Some implementations of the implant catheter include sections where a portion of the coil layer is free from all material of the outer jacket. In some implementations, a portion of a layer internal to the catheter is omitted. Some implementations include a coil formed form wire with a self-aligning cross-section.

A tension-distribution device includes a rotationally-symmetric structure and two or more suture-engagement features associated with the rotationally-symmetric structure, the suture-engagement features being configured to receive one or more suture portions therein. The two or more suture-engagement features are evenly spaced rotationally about an axial center of the rotationally-symmetric structure.

Improvements to devices, systems, and methods for delivering and/or deploying an implantable medical device are described. An implantable medical device may include an annuloplasty ring for implantation on a valve of a patient. Systems and methods may be configured to present graphical user interfaces with device images to implement efficient and accurate implantation of the implantable medical device. The device images may be based on sensor information obtained via sensors associated with the implantable medical device, such as a camera device, a diagnostic imaging device, position sensors, and/or the like. In other aspects, systems and methods may determine optimized configurations for the implantable medical device based on device characteristics including, without limitation, a shape formed by components of the implantable medical device and/or component coordinate information. Systems and methods may operate to facilitate deployment of the implantable medical device to correspond with the optimized configuration. Other embodiments are described.

A fixation device for engaging heart valve leaflets includes a center member with a first end, an opposite second end, and a length extending therebetween, first and second arms each having a first free end and an opposite second end, the second end of each arm extending from the second end of the center member, the first and second arms biased in a first position adjacent the center member and moveable to a second position spaced apart from the center member, and an actuator configured to move the first and second arms from the first position to the second position.

A delivery system for prosthetic heart valves are provided. The delivery system includes a flexible shaft, a distal sheath capsule configured to contain the prosthetic heart valve, an inner steerable catheter including an inner distal flex component, and an outer steerable catheter including an outer distal flex component. The inner distal flex component includes a first cut pattern and a second cut pattern distal to the first cut pattern. The outer distal flex component includes a third cut pattern. The inner steerable catheter is rotatable at least 90 degrees relative to the outer steerable catheter when the third cut pattern of the outer distal flex component is disposed over at least a portion of the first cut pattern of the inner distal flex component and each of the inner steerable catheter and the outer steerable catheter is in the flexed configuration.

A tissue-engaging element is advanced to a heart, while coupled to a guide member. The tissue-engaging element is then coupled to tissue of the heart. An elongate implant is subsequently slid distally along the guide member toward the tissue-engaging element, and the elongate implant is subsequently locked to the tissue-engaging element. Other embodiments are also described.