Disclosed herein is a delivery system for percutaneous heart valve repair, the delivery system including a steerable sheath configured to provide percutaneous access into a heart and to deliver an implant. The system may also have a steering mechanism configured to manipulate and orient the implant, a ball joint mechanism configured to connect the steerable sheath to the steering mechanism, a main knob assembly configured to advance and retract a multilumen shaft assembly, a stabilizing tool including a plurality of prongs configured to engage the implant within the heart to make an intimate contact with the heart tissue using a stabilizer and a tongue assembly, and a back assembly including: the actuation mechanism, a suture routing mechanism, a tip lock mechanism, and a back cover configured to protect all sutures being cut by mistake.

A prosthetic valve may be formed to direct flow out of the outflow orifice toward a posterior portion of a heart wall. The prosthetic valve includes an expandable frame which may be covered with a cover that is suturelessly attached to the frame. The prosthetic valve may also include an outflow orifice size which is controlled. Methods of using these devices are also disclosed.

Apparatus, systems, and methods are provided for repairing heart valves through percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves. An annuloplasty ring includes an outer hollow body member including a plurality of regions. Adjacent regions cooperate with one another to change the body member from an elongate insertion geometry to an annular operable geometry. Adjacent regions are coupled by a biasing element or a stepped connector to allow expansion to an expanded state and contraction to a contracted state in the annular operable geometry. The annuloplasty ring also includes an internal anchor member located at least partially within the body member and having a plurality of anchors configured to attach the annuloplasty ring to tissue of a heart valve annulus. An angled ring closure lock allows coupling of the ends of an annuloplasty ring at an apex of a D-shape annular operable geometry.

A valve-in-ring annuloplasty device according to the present technology includes a body coupled to an annuloplasty ring. The body is configured to align an artificial valve coaxially with the annuloplasty ring to reduce complications cause by misalignment of the artificial valve. A chamber wall, extending through the annuloplasty ring from a base portion configured to be attached to a valve annulus, is used to align the artificial valve during deployment. The chamber wall may include a plurality of struts configured to increase a rigidity of the chamber wall in the coaxial direction to ensure proper deployment of the artificial valve. The base portion may provide an increased suture area that decreases a likelihood for paravalvular leaking around the annuloplasty ring.

An apparatus for repairing or replacing a mitral valve and a method of using same are disclosed. The apparatus has an atrial band securable to a ring-shaped ventricular band. The ventricular band has an anterior band and a posterior band connectable to the anterior band. The atrial and anterior bands each have a pair of apertures. Each of the apertures is positioned proximate to a respective terminal end of the bands. The apertures of the atrial and anterior bands are arranged to align with one another when their inner surfaces engage. Means are provided to secure the atrial band to the anterior band. When delivered and implanted, the apparatus is arranged to extend across the commissures of the heart, with atrial and anterior bands arranged to press against the atrial and ventricular surfaces of the mitral valve leaflets respectively.

A knotless suture fastener installation system for securing medical devices such as cardiac implants. The knotless suture fasteners may be spring-biased so as to grip onto sutures passed therethrough. The system includes a fastener deployment tool with a proximal handle and a distal shaft to which a fastener cartridge attaches. A plurality of disposable cartridges are sequentially attached to the end of the deployment tool and used to secure the medical implant one fastener at a time. The deployment tool may also cut the sutures being fastened.

A minimally-invasive annuloplasty ring for implant at a mitral annulus. The annuloplasty ring has an inner core member with a C-shaped plan view that generally defines an oval with a major axis and a minor axis, and is symmetric about the minor axis. A posterior portion of the core member bisected by the minor axis has a thicker radial dimension than a pair of free end regions terminating on an anterior side of the core member. The radial thickness smoothly transitions between the posterior portion and the end regions. The inner core member may be covered with a fabric, and is a superelastic metal so that it can be straightened out and delivered through an access tube. The curvatures and thicknesses around the core member are selected so that the strain experienced when straightened does not exceed 7-8%.

Annuloplasty device for use on a posterior annulus of a mitral valve, which is deployable to the mitral valve by means of a vascular delivery device, such as a catheter, and positionable along the curvature of the annulus, including at least a first and a second branch, each configured to extend along at least a section of the annulus, with a first end and a second end, at least one guiding means for guiding the first and the second branches relative to one another, at least one fixing means for fixing the device to the annulus, and at least one anchor means arranged on each of the first and second branches, whereby the first and the second branches are movable relatively to one another, so that the anchor means engage with the annulus thereby pulling the annulus together when the first and second branches are moved in opposite directions.

An annuloplasty band and method of implantation. The band is shaped and sized to avoid the adjacent aortic valve structure and better protects against dehiscence along the muscular mitral annulus. The band is asymmetric and when implanted spans more around the side of the mitral annulus having the posterior commissure than the side with the anterior commissure. The band has a saddle shape with a posterior upward bow centered on a minor axis of the mitral annulus, and a span extending clockwise therefrom is longer than a span extending counter-clockwise. The longer span may be 150° while the shorter span extends 90°. A set of rings may have different saddle profiles and different plan view shapes for different sized bands. A method includes implanting so that the band extends over the posterior leaflet and a short distance past the posterior commissure outside of the anterior leaflet.

An implantable valve replacement system for a cardiovascular valve may include an adjustable stabilizing ring. The stabilizing ring may be composed of a body member that is transitionable from an elongate insertion geometry to an annular operable geometry. The stabilizing ring may further include a plurality of anchors deployable in the annular operable geometry to engage the annulus of the cardiovascular valve. The ring may be used in conjunction with an implantable valve frame. The valve frame may be located within the ring and the ring, in turn, may be stabilized through the anchors engaging the valve annulus. The valve replacement system may be applied by engaging the ring in its annular operable geometry with the valve annulus through the anchors. The valve frame may be inserted through the opening of the ring, thereby forming a stabilizing mechanical contact between the frame and the annulus.