Transluminal mitral annuloplasty with active anchoring

1. A method of performing transluminal mitral annuloplasty, comprising the steps of:

providing a catheter, having a prosthesis thereon;

inserting the catheter into the venous system;

transluminally advancing the prosthesis into the coronary sinus such that a distal end portion of the prosthesis is in contact with an inner wall of the coronary sinus;

actuating a pull wire on the catheter to actively advance at least one tissue anchor on the distal end portion from a retracted position to an extended position; and

manipulating a component of the prosthesis to cause the prosthesis to exert force on the mitral valve annulus.

2. A method as in claim 1 , further comprising the step of percutaneously accessing the venous system prior to the transluminally advancing step.

3. A method as in claim 2 , wherein the accessing step is accomplished by accessing one of the internal jugular, subclavian and femoral veins.

4. A method as in claim 1 , further comprising the steps of first measuring the coronary sinus and then selecting an appropriately sized prosthesis prior to the inserting step.

5. A method as in claim 1 , further comprising the step of measuring hemodynamic function following the manipulating a component of the prosthesis step.

6. A method as in claim 5 , further comprising the step of determining an ongoing drug therapy taking into account the post implantation hemodynamic function.

7. A method as in claim 1 , wherein the advancing at least one tissue anchor step comprises advancing the anchor from an axial orientation to an inclined orientation.

8. A method as in claim 7 , wherein the tissue anchor has a proximal end for piercing tissue and a distal point of attachment to the prosthesis, and the advancing at least one tissue anchor step comprises rotating the anchor about the point of attachment.

9. A method as in claim 1 , comprising advancing at least two tissue anchors to an extended position.

10. A method as in claim 8 , comprising advancing at least two tissue anchors to an extended position.

11. A method as in claim 1 , wherein the manipulating a component of the prosthesis step causes the prosthesis to transform into a curved configuration having a first side facing towards the mitral valve annulus and a second side facing away from the mitral valve annulus.

12. A method as in claim 11 , wherein the tissue anchor is configured to be advanced in the direction of the mitral valve annulus.

13. A method as in claim 1 , wherein the manipulating step comprises axially moving a forming element with respect to the prosthesis, to bend the prosthesis.

14. A method as in claim 1 , further comprising the step of locking the prosthesis to retain a force on the annulus following the manipulating step.

15. A method as in claim 14 , wherein the locking step comprises moving an engagement surface from a disengaged configuration to an engaged configuration.

16. A method as in claim 14 , wherein the locking step comprises providing an interference fit.

17. A method as in claim 14 , wherein the locking step is accomplished with a threaded engagement.

18. A method as in claim 5 , wherein the step of monitoring hemodynamic function is accomplished using transesophageal echo cardiography.

19. A method as in claim 5 , wherein the step of monitoring hemodynamic function is accomplished using surface echo cardiographic imaging.

20. A method as in claim 5 , wherein the step of monitoring hemodynamic function is accomplished using intracardiac echo cardiographic imaging.

21. A method as in claim 5 , wherein the step of monitoring hemodynamic function is accomplished using fluoroscopy with radiocontrast media.

22. A method as in claim 5 , wherein the step of monitoring hemodynamic function is accomplished using left atrial or pulmonary capillary wedge pressure measurements.