Prosthesis for annuloplasty comprising a perforated element

1. An annuloplasty prosthesis for implantation in a cardiac valve annulus, the prosthesis comprising:

a monolithic ring element having a longitudinal axis, a curved portion, and a generally straight portion, the curved portion having a first end region and a second end region, the generally straight portion extending between the first end region and the second end region; and

a plurality of apertures disposed along substantially the entire curved portion, wherein the apertures are oriented generally transverse to the longitudinal axis, and further wherein at least one of a size, a shape, or a position of each aperture is selected such that the curved portion is more flexible than at least a portion of the straight portion.

2. The prosthesis of claim 1 wherein at least one of a size, a shape, or a position of each aperture is selected such that the ring element has a differentiated flexibility depending on the location and direction of application of an external stress.

3. The prosthesis of claim 1 wherein the curved portion has a center region and first and second end portions, and wherein at least one of a size, a shape, or a position of each aperture is selected such that the curved portion is more flexible near the center region than near the end portions.

4. The prosthesis of claim 1 wherein the ring element is covered by one or more biocompatible materials.

5. The prosthesis of claim 4 wherein the one or more biocompatible materials are chosen from the group consisting of polymers, synthetic textiles, and biological tissues.

6. The prosthesis of claim 4 wherein at least a portion of a surface of the one or more biocompatible materials is clad with hemocompatible carbon.

7. The prosthesis of claim 1 wherein the ring element has an internal cavity, and wherein the internal cavity is at least partially filled with an elastomeric material.

8. The prosthesis of claim 7 wherein the ring element is covered by a textile sheath.

9. The prosthesis of claim 8 wherein at least a portion of the sheath is clad with hemocompatible carbon.

10. An annuloplasty prosthesis comprising:

a monolithic ring element having a size and a shape generally corresponding to a cardiac valve annulus and including a longitudinal axis, a first portion having first and second end regions, and a second portion extending between the first end region and the second end region; and

a plurality of apertures disposed along substantially the entire first and second portions, wherein the apertures are configured or disposed in such a way that the first portion is more flexible than the second portion, and further wherein at least some of the apertures are oriented generally transverse to the longitudinal axis.

11. The prosthesis of claim 10 wherein the apertures are configured or disposed in such a way that the ring element has a differentiated flexibility depending on the location and direction of application of an external stress.

12. The prosthesis of claim 10 wherein the ring element is covered by one or more biocompatible materials.

13. The prosthesis of claim 12 wherein the one or more biocompatible materials are chosen from the group consisting of polymers, synthetic textiles, and biological tissues.

14. The prosthesis of claim 12 wherein at least a portion of a surface of the one or more biocompatible materials is clad with hemocompatible carbon.

15. The prosthesis of claim 10 wherein the ring element has an internal cavity, and wherein the internal cavity is at least partially filled with an elastomeric material.

16. The prosthesis of claim 15 wherein the ring element is covered by a textile sheath.

17. The prosthesis of claim 16 wherein at least a portion of a sheath is clad with hemocompatible carbon.

18. An annuloplasty prosthesis comprising:

a monolithic ring element configured for implantation in a cardiac valve annulus and having a longitudinal axis, a first portion having first and second end regions, and a second portion extending between the first end region and the second end region; and

a plurality of apertures disposed along substantially the entire first portion, wherein each aperture is oriented generally transverse to the longitudinal axis and sized, shaped, or positioned along at least the first portion such that the first portion is more flexible than at least a part of the second portion.

19. The prosthesis of claim 18 wherein at least two of a size, a shape, or a position of each aperture are selected such that the first portion is more flexible than at least a part of the second portion.

20. The prosthesis of claim 18 wherein each aperture is sized, shaped, or positioned such that the ring element has a differentiated flexibility depending on the location and direction of application of an external stress.

21. The prosthesis of claim 18 wherein the prosthesis is generally planar, and wherein each aperture is sized, shaped, or positioned such that the ring element has a first flexibility in response to a first external stress acting in the general plane of the prosthesis and a second flexibility in response to a second external stress acting generally transverse to the general plane of the prosthesis.

22. The prosthesis of claim 18 wherein the ring element is covered by one or more biocompatible materials selected from the group consisting of polymers, synthetic textiles, and biological tissues.

23. The prosthesis of claim 22 wherein at least a portion of a surface of the one or more biocompatible materials is clad with hemocompatible carbon.

24. The prosthesis of claim 18 wherein the ring element has an internal cavity, and wherein the internal cavity is at least partially filled with an elastomeric material.

25. The prosthesis of claim 24 wherein the ring element is covered by a textile sheath.

26. The prosthesis of claim 25 wherein at least a portion of a sheath is clad with hemocompatible carbon.