Valtech Cardio Ltd.

Edwards Lifesciences Innovation (Israel) Ltd.

Cardiovalve Ltd.

Mitraltech Ltd.

Cardiovale Ltd.

Mitraltech Ltd. 3 Ariel Sharon Avenue

Edwards Lifesciences Corporation

Edwards Lifesciences Innovation Ltd.

Tal Reich

Amir Gross

Eran Miller

Yuval Zipory

Tal Hammer

Tal Sheps

Yaron Herman

Oz Cabiri

Gil Hacohen

Ehud Iflah

Yossi Gross

Alexei Koifman

Meir Kutzik

Ilia Hariton

Natalia Kruglova

Meni Iamberger

Aviram Baum

Yosef Gross

Yaron Keidar

Stanton J Rowe

Boaz Manash

Francesco Maisano

Ehud Aviv

Haim Brauon

Rotem Neeman

Michael Albitov

Eran Hoffer

Hengchu Cao

Uriel Aba Pomerantz

Kevin K Dang

Eran Goldberg

Yoseph Weitzman

Paul Kaye

Omar Fawzi Azanki

Brian Patrick Murphy

Praveen De Silva

Carmel Peleg

Gili Hacohen

Slava Starobinsky

Michael Levin

Alon Fogel

Nima V Nia

Assaf Sharon

Yuval Kasher

Luis Molina

Tal Benshahar

Amit Peer

Sarit Avivi

Tomer Golan

Aaron Anan Ness

Sam Shafigh

Lior Haroosh

Or Cohen

Gad Tennenbaum

Ben Azouri

Bezalel Haberman Browns

Jeong Soo Lee

Or Chernin

Shlomit Chappel-Ram

Vadim Gordon

Eva Cruz Romito

An annuloplasty implant is implanted along a valve annulus of a heart of a subject using a driver that includes a flexible shaft and a deployment element at a distal end of the shaft by, for each of the anchors in turn, beginning with the distal anchor: (1) using the driver to move the anchor out of a corresponding anchor-storage area of a tool; (2) advancing the anchor distally through a tube of the tool, with the shaft of the driver extending past the anchor-storage area; (3) anchoring the anchor to tissue of the heart; (4) disengaging the driver from the anchor; and (5) retracting the driver proximally beyond the corresponding anchor-storage area and, at a successively-proximal anchor-storage area, engaging the anchor with the successive anchor. Other embodiments are also described.

Multiple anchor delivery tool

System for use with tissue of a heart comprises a tissue anchor comprising an engaging head that has a coupling eyelet that defines an eyelet plane, and a helical tissue-coupling element, reversibly anchorable to the tissue, and having a central helix axis that lies on the eyelet plane. The system also comprises an anchor driver, having a distal portion that has a casing that defines a slot, the slot defining a slot plane, and dimensioned to receive at least part of the eyelet therein in a manner in which the eyelet plane is coplanar with the slot plane. The anchor driver also comprises a detent, configured to reversibly inhibit movement of the eyelet with respect to the slot. The anchor driver is configured to anchor the tissue anchor to the tissue by rotating the tissue anchor by applying a rotational force to the eyelet. Other embodiments are also provided.

Percutaneous tissue anchor techniques

An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. A tissue anchor is stored in the anchor-storage zone. The anchor-handing device is configured such that, while the tissue anchor is stored in the anchor-storage zone, the tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening by the element moving in response to the proximally-directed force. Other embodiments are also described.

Anchor magazine

During a percutaneous transcatheter procedure, an annuloplasty structure is secured at least partially around an annulus of a mitral valve of a subject by coupling a plurality of tissue anchors to the annulus such that (i) a longitudinal contracting member of the annuloplasty structure extends at least partially around the annulus, and (ii) the plurality of tissue anchors is distributed at least partially around the annulus. A longitudinal density of the anchors along a middle scallop of a posterior leaflet of the mitral valve is at least twice as great as a longitudinal density of the anchors along a lateral scallop of the posterior leaflet, and/or at least twice as great as a longitudinal density of the anchors along a medial scallop of the posterior leaflet. Thereafter, at least part of the annulus is contracted by contracting a longitudinal portion of the annuloplasty structure by tightening the longitudinal contracting member.

Percutaneous implantation of an annuloplasty structure

Methods, systems, and apparatuses for treating a heart are provided. Methods can include obtaining and using an implant. One or more catheters can be used to properly position and attach the implant in a desired location in a chamber of the heart, for example, such that (i) a first portion of the implant is anchored to a first site on a wall of the chamber, (ii) a second portion of the implant is anchored to a second site on the wall of the chamber, (iii) a mid-portion of the implant extends in a curved path along the wall of the chamber between the first site and the second site, and (iv) an elongate contraction member of the implant cuts across the chamber between the first site and the second site. Other embodiments are described.

Cinching of dilated heart muscle

Apparatus is provided for repairing a cardiac valve, the apparatus including a catheter sized for delivery through vasculature of a subject and an elongated and flexible annuloplasty structure having an annuloplasty structure axis. The annuloplasty structure is sized and configured for delivery to a heart of the subject through the catheter substantially along a catheter axis of the catheter while the annuloplasty structure axis is substantially parallel to the catheter axis. The apparatus also includes a plurality of anchors configured for delivery to a region of cardiac tissue from a proximal end of the catheter toward a distal end of the catheter and substantially along the annuloplasty structure axis and the catheter axis while at least a portion of the annuloplasty structure is within a delivery passage of the catheter. Other embodiments are also described.

Annuloplasty ring delivery catheters

An implantable prosthetic device for repairing a native valve includes a first clip, a second clip, a first cord, and a second cord. The first clip has a first arm and a second arm and is moveable between an open position and a closed position. The second clip has a third arm and a fourth arm and is moveable between an open position and a closed position. The first cord is operatively coupled to the first clip for moving the first clip between the open and closed position. The second cord is operatively coupled to the second clip for moving the second clip between the open and closed position. The device is configured to clamp a first leaflet of the native mitral valve between the first arm and the second arm and to clamp a second leaflet of the native mitral valve between the third arm and the fourth arm.

Method and apparatus for repairing a heart valve

A method, for use at a mitral valve of a heart of a subject, is provided which includes advancing a transluminal sheath into a femoral vein of the subject, through an inferior vena cava of the subject, into a right atrium of the subject, and transseptally into a left atrium of the subject. A surrounding-sheath is advanced out of a distal end of the transluminal sheath, into the left atrium, and toward a commissure of the mitral valve. An anchor is implanted by advancing the anchor out of the surrounding-sheath into a left ventricle of the subject, such that the anchor helically wraps around left ventricular mitral valve tissue. The surrounding-sheath is then extracted from the heart and then, a guide wire is advanced through the transluminal sheath. Other embodiments are also described.

Helical anchor implantation

An implant structure, comprises a body portion, a first adjusting mechanism, and a second adjusting mechanism. The body portion is configured to be secured within a heart of a patient. The first adjusting mechanism is coupled to a first portion of the body portion, and comprises a first ring that surrounds the first portion and is moveable with respect to the body portion. The second adjusting mechanism is coupled to a second portion of the body portion, and comprises a second ring that surrounds the second portion and is moveable with respect to the body portion. A first elongate tool is configured to remodel tissue of the heart by actuating the first adjusting mechanism. A second elongate tool is configured to remodel tissue of the heart by actuating the second adjusting mechanism.

Implant having multiple adjusting mechanisms

A tubular system is configured to transluminally deliver an implant comprising a tissue anchor having a coupling head and a distal helical tissue-engaging element, into a heart of a subject. The tissue anchor is slidable through a channel of the system, the channel being slidable within a catheter. An anchor driver is configured, while coupled to the coupling head of the tissue anchor, to drive the tissue anchor through the system and out the system's distal end, to anchor the tissue-engaging element to tissue of the heart. While a first electrode is in contact with the subject and a second electrode is inside the heart of the subject, a control unit receives an electrophysiological signal from the electrodes, and based on the electrophysiological signal, indicates a position of the second electrode inside the heart. Other embodiments are also described.

Location indication system for implant-delivery tool

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.

Techniques for guide-wire based advancement of a tool

An apparatus is provided for use with a tissue anchor and an anchor driver. The apparatus includes a housing, shaped to define a channel. The channel includes (i) an anchor-storage zone, and (ii) a proximal opening configured to provide access for the anchor driver to the anchor-storage zone. The channel is configured to enable sliding of the tissue anchor therewithin to be stored in the anchor-storage zone. The apparatus also includes a retaining member, shaped to define a cradle for cradling and holding the tissue anchor in the anchor-storage zone. The retaining member includes a pillar pivotable with respect to the cradle, and configured to support the tissue anchor at the cradle. Other embodiments are also described.

Tissue anchor handling systems and methods

A guidewire is slidable through a percutaneous medical device. A distal end of the percutaneous medical device is moved in a proximal direction away from an anatomical site of a body of a subject. Simultaneously, a position of a distal end of the guidewire, with respect to the anatomical site, is maintained by moving a housing toward another housing that is coupled to the medical device. Other embodiments are also described.

Guidewire feeder

A method for treating a native heart valve of a patient includes anchoring a plurality of anchors of an implant into tissue around an annulus of the valve. At the annulus, a force-distribution element is incorporated into the implant such that the force-distribution element extends along a longitudinal portion of the elongate contracting member. The method can also include circumferentially tightening the annulus by pulling the plurality of anchors closer together, such as by actuating a contracting mechanism of a contracting system, such that (i) the contracting mechanism, coupled to an elongate contracting member of the implant, applies a longitudinal tensioning force to the elongate contracting member, and (ii) the force-distributing element distributes the longitudinal tensioning force over at least two of the anchors. Other embodiments are also described.

Annuloplasty implants

A method is described for use with a heart of a subject, the heart having a valve and an atrium upstream of the valve. The method includes transluminally advancing multiple tissue anchors to the atrium; and securing an elongate contraction member at least partly around an annulus of the valve by anchoring the tissue anchors to the annulus, such that the tissue anchors are distributed along the elongate contraction member. The method further includes subsequently contracting the annulus by applying tension the elongate contraction member, such that a radiopaque indicator that is disposed within the heart and that is coupled to the contraction member undergoes a conformational change in response to the tension. The conformational change of the radiopaque indicator within the heart is observed, and the tension is adjusted responsively to the observed conformational change. Other embodiments are also described.

Annuloplasty technologies

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Moshav Moledet, Israel

Tal Reich