Implantation of repair devices in the heart

Abstract

Apparatuses, systems, and devices usable for valve repair are provided. These can include a valve repair system comprising an annuloplasty structure positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube or plurality of tubes. One or more tissue anchors are deliverable through the tube or plurality of tubes, the tissue anchor(s) being shaped so as to each define a tissue coupling element. The tissue coupling element(s) can be deployed from the distal end of the tube or plurality of tubes in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.

1 . An apparatus for heart valve repair, comprising
 a handle,   a plurality of tubes coupled to the handle and having flexible distal portions,   a tubular annuloplasty structure configured to be implanted at a heart valve annulus and defining a lumen therethrough, the annuloplasty structure comprising a contracting wire disposed within the lumen of the annuloplasty structure and a plurality of anchor mounts, wherein a portion of the contracting wire extends out of the lumen of the annuloplasty structure so that a size of the annuloplasty structure is adjustable,   wherein a distal end of each of the plurality of tubes is coupled to a respective anchor mount and each of the plurality of tubes is preloaded with an anchor coupled to an anchor advancement system, the anchor advancement system configured to advance the anchor through the tube and toward the anchor mount coupled to the tube so as to anchor the anchors to heart tissue and thereby anchor the annuloplasty structure to the heart valve annulus.   
     
     
         2 . The apparatus of  claim 1 , wherein the anchor advancement system is a rod. 
     
     
         3 . The apparatus of  claim 1 , wherein the anchor advancement system is actuated from the handle. 
     
     
         4 . The apparatus of  claim 1 , wherein the plurality of tubes is coupled to a distal end of the handle. 
     
     
         5 . The apparatus of  claim 1 , wherein the plurality of tubes are coupled and bound together by stabilizing rings. 
     
     
         6 . The apparatus of  claim 1 , wherein a sheath surrounds the plurality of tubes. 
     
     
         7 . The apparatus of  claim 6 , wherein the sheath has a distal end hermetically sealed to a ring and a proximal end hermetically sealed to a distal end of the handle. 
     
     
         8 . The apparatus of  claim 1 , wherein each of the plurality of tubes comprises a coupling element coupling the tube to a respective anchor mount. 
     
     
         9 . The apparatus of  claim 1 , wherein the contracting wire is coupled to at least one ring of the handle, wherein the size of the annuloplasty structure is adjustable by rotation of the at least one ring. 
     
     
         10 . The apparatus of  claim 1 , wherein the annuloplasty structure is compressible. 
     
     
         11 . The apparatus of  claim 1 , wherein the annuloplasty structure is formed of a braided mesh. 
     
     
         12 . A system for heart valve repair, comprising
 a handle,   a plurality of tubes coupled to the handle and having flexible distal portions,   an annuloplasty structure configured to be implanted at a heart valve annulus, the annuloplasty structure comprising a contracting wire, wherein a size or shape of the annuloplasty structure is adjustable by adjusting tension in the contracting wire,   wherein a distal end of each of the plurality of tubes is coupleable to the annuloplasty structure and each of the plurality of tubes is preloaded with a respective anchor coupled to an anchor advancement system, the anchor advancement system configured to advance each respective anchor through a respective tube of the plurality of tubes so as to anchor each respective anchor to heart tissue and thereby anchor the annuloplasty structure to the heart valve annulus.   
     
     
         13 . The system of  claim 12 , wherein the anchor advancement system is a rod. 
     
     
         14 . The system of  claim 12 , wherein the anchor advancement system is actuated from the handle. 
     
     
         15 . The system of  claim 12 , wherein the plurality of tubes is coupled to a distal end of the handle. 
     
     
         16 . The system of  claim 12 , wherein the plurality of tubes are coupled and bound together by stabilizing rings. 
     
     
         17 . The system of  claim 12 , further comprising a sheath that can surround the plurality of tubes. 
     
     
         18 . The system of  claim 17 , wherein the sheath has a distal end hermetically sealed to a ring and a proximal end hermetically sealed to a distal end of the handle. 
     
     
         19 . The system of  claim 12 , wherein each of the plurality of tubes comprises a coupling element coupling the tube to a respective anchor mount. 
     
     
         20 . The system of  claim 12 , wherein the contracting wire is coupled to at least one ring of the handle, wherein the size of the annuloplasty structure is adjustable by rotation of the at least one ring. 
     
     
         21 . The system of  claim 12 , wherein the annuloplasty structure comprises a braided mesh. 
     
     
         22 . A system for heart valve repair, comprising
 a handle,   a plurality of tubes coupled to a distal end of the handle and having flexible distal portions,   a sheath surrounding at least a portion of the plurality of tubes,   a braided tubular annuloplasty structure configured to be implanted at a heart valve annulus and defining a lumen therethrough, the annuloplasty structure comprising a contracting wire disposed within the lumen of the annuloplasty structure and a plurality of anchor mounts, wherein a portion of the contracting wire extends out of the lumen of the annuloplasty structure so that a size of the annuloplasty structure is adjustable,   wherein a distal end of each of the plurality of tubes is couplable to a respective anchor mount and each of the plurality of tubes is preloaded with an anchor coupled to an anchor advancement system, the anchor advancement system configured to advance each respective anchor through a respective tube of the plurality of tubes and toward the anchor mount coupled to the respective tube so as to anchor each respective anchor to heart tissue and thereby anchor the annuloplasty structure to the heart valve annulus, and   wherein when anchoring each respective anchor to the heart tissue, distal regions of the plurality of tubes are curved radially outwardly.