Guided advancement of an implant

Abstract

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.

1 . A method for use with a heart of a subject, the method comprising:
 advancing, into the heart, a tissue-engaging element coupled to a guide member;   coupling the tissue-engaging element to tissue of the heart;   subsequently, sliding an elongate implant distally along the guide member toward the tissue-engaging element; and   subsequently, locking the elongate implant to the tissue-engaging element.   
     
     
         2 . The method according to  claim 1 , wherein sliding the elongate implant comprises transluminally sliding the elongate implant to the heart. 
     
     
         3 . The method according to  claim 1 , further comprising decoupling the guide member from the tissue-engaging element while the elongate implant remains locked to the tissue-engaging element. 
     
     
         4 . The method according to  claim 1 , wherein the tissue is tissue of a ventricle of the heart, and wherein coupling the tissue-engaging element to the tissue of the heart comprises coupling the tissue-engaging element to the tissue of the ventricle. 
     
     
         5 . The method according to  claim 4 , wherein the method further comprises coupling a proximal end of the elongate implant to a valve leaflet of the heart that is upstream of the ventricle. 
     
     
         6 . The method according to  claim 5 , wherein the method further comprises, subsequently to coupling the proximal end of the elongate implant to the valve leaflet, adjusting a distance between the proximal end of the elongate implant and the tissue-engagement element. 
     
     
         7 . The method according to  claim 4 , wherein the tissue is tissue of a papillary muscle of the heart, and wherein coupling the tissue-engaging element to the tissue of the heart comprises coupling the tissue-engaging element to the tissue of the papillary muscle. 
     
     
         8 . The method according to  claim 1 , wherein sliding the elongate implant distally along the guide member comprises sliding a tool, while the tool is coupled to the elongate implant, distally along the guide member such that the elongate implant slides distally along the guide member towards the tissue-engaging element. 
     
     
         9 . The method according to  claim 8 , wherein locking the elongate implant to the tissue-engaging element comprises locking the elongate implant to the tissue-engaging element using the tool. 
     
     
         10 . The method according to  claim 1 , wherein locking the elongate implant to the tissue-engaging element comprises locking an adjustment mechanism of the elongate implant to the tissue-engaging element. 
     
     
         11 . The method according to  claim 10 , the method further comprising, subsequently to locking the adjustment mechanism to the tissue-engaging element, actuating the adjustment mechanism to adjust tension in the elongate implant. 
     
     
         12 . The method according to  claim 10 , the method further comprising, subsequently to locking the adjustment mechanism to the tissue-engaging element, actuating the adjustment mechanism to adjust a length of the elongate implant. 
     
     
         13 . A system for use with a heart of a subject, the system comprising:
 a tissue-engaging element anchorable to tissue of the heart;   a guide member, reversibly coupled to the tissue-engaging element;   an elongate implant; and   a tool configured to, while the tissue-engaging element is anchored to tissue of the heart and the guide member is coupled to the tissue-engaging element:
 slide the elongate implant over and along the guide member toward the tissue-engaging element, and 
 subsequently, lock the elongate implant to the tissue-engaging element. 
   
     
     
         14 . The system according to  claim 13 , wherein the tool is configured to transluminally slide the elongate implant over and along the guide member toward the tissue-engaging element. 
     
     
         15 . The system according to  claim 13 , wherein the tool is configured to decouple the guide member from the tissue-engaging element while the elongate implant remains locked to the tissue-engaging element. 
     
     
         16 . The system according to  claim 13 , wherein the tissue is tissue of a ventricle of the heart, and wherein the tool is configured to:
 slide the elongate implant over and along the guide member into the ventricle, and   lock the elongate implant to the tissue-engaging element within the ventricle.   
     
     
         17 . The system according to  claim 13 , wherein the tissue-engaging element is helical and is configured to be corkscrewed into the tissue. 
     
     
         18 . The system according to  claim 13 , wherein the tool is configured to couple a proximal end of the elongate implant to a valve leaflet of the heart. 
     
     
         19 . The system according to  claim 18 , wherein the implant comprises a leaflet-engaging element at the proximal end of the elongate implant, and wherein the tool is configured to couple the proximal end of the elongate implant to the valve leaflet by coupling the leaflet-engaging element to the leaflet. 
     
     
         20 . The system according to  claim 13 , wherein the implant comprises, at a distal end of the elongate implant, an adjustment mechanism configured to adjust tension in the elongate implant upon actuation of the adjustment mechanism. 
     
     
         21 . The system according to  claim 20 , wherein the tool is configured to lock the elongate implant to the tissue-engaging element by locking the adjustment mechanism to the tissue-engaging element. 
     
     
         22 . The system according to  claim 20 , wherein the tool is configured to actuate the adjustment mechanism. 
     
     
         23 . The system according to  claim 20 , wherein the adjustment mechanism comprises a rotatable structure disposed within a housing, actuation of the adjustment mechanism comprising rotation of the rotatable structure with respect to the housing.