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.

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.

A valve prosthesis and methods for implanting the prosthesis are provided. The prosthesis generally includes a self-expanding frame and two or more engagement arms. A valve prosthesis is sutured to the self-expanding frame. Each engagement arm corresponds to a native mitral valve leaflet. At least one engagement arm immobilizes the native leaflets, and holds the native leaflets close to the main frame. The prosthetic mitral valve frame also includes two or more anchor attachment points. Each anchor attachment point is attached to one or more anchors that help attach the valve prosthesis to the heart.

An anchor is shaped to define a helix. A deployment tool is reversibly coupled to the anchor, and includes a lance. The deployment tool is configured to transluminally advance the anchor to the heart, and to stabilize the anchor at the tissue by driving the lance into the tissue. The deployment tool is also configured to anchor the anchor to the tissue, for example, by driving the tissue-penetrating helix into the tissue while the anchor remains stabilized at the tissue by the lance in the tissue, and to subsequently retract the lance from the tissue while leaving the anchor anchored to the tissue. Other embodiments are also described.

Methods and devices for transvascular prosthetic chordae tendinae 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.

A suture system can comprise a first and a second curved double arm needle, and a needle docking device configured to maintain the first and the second curved double arm needles in alignment with and parallel to one another and at predetermined orientations relative to the needle docking device. The system can include a needle manipulating instrument having a distal portion configured to engage the first and the second curved double arm needles while the first and second curved double arm needles are in the needle docking device, and to maintain the needles in predetermined orientations.

An artificial chordae tendineae includes a chordae tendineae main body with at least one end connected to a fixing member. A side of the fixing member facing away from the chordae tendineae main body is provided with a puncturing connection member. An artificial chordae tendineae implantion system includes a clamping device, a puncturing device including a puncture needle, the artificial chordae tendineae, and a pushing device including a pushing shaft. The puncturing device and the clamping device are received in the pushing shaft. A proximal clamp of the clamping device is provided at a distal end of the pushing shaft. A distal clamp of the clamping device is provided at a distal end of the clamping push rod. A distal end of the puncture needle is provided with a tapped straight tip. The artificial chordae tendineae is received in the clamping device. The fixing member corresponds to the puncture needle.

A valve repair device for repairing a native valve of a patient includes a pair of paddles and a pair of gripping members. The pair of paddles are movable between an open position and a closed position. Each paddle comprises a metal loop that is moveable from a compressed condition where each metal loop has a first width to an expanded condition where each loop has a second width that is greater than the first width. The pair of gripping members are configured to attach to the native valve of the patient.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet connector carried by a distal end of the catheter can be anchored to a superior surface of a mitral valve leaflet. A needle is axially advanceable through the leaflet connector and through the leaflet. A leaflet anchor having a leaflet suture can be advanced out of the needle to secure the mitral valve leaflet to the 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.

A delivery device includes an inner shaft, an outer sheath, a nosecone, and a tether component. The outer sheath is slidably disposed over the inner shaft. The nosecone is removably coupled to the inner shaft. The nosecone includes a delivery configuration for delivery to a treatment site, a radially compressed configuration in which a portion of the nosecone is configured to traverse through a heart wall, and a radially expanded configuration in which an outer surface of the nosecone contacts an outer surface of the heart wall. The tether component includes a first end coupled to the nosecone. The nosecone is configured to plug a piercing in the heart wall when in the radially expanded configuration.