Helical anchor implantation
A transluminal sheath is advanced into a femoral vein of a subject, through an inferior vena cava of the subject, into a right atrium of a heart of the subject, and transseptally into a left atrium of the heart. A surrounding-sheath is advanced out of a distal end of the transluminal sheath, into the left atrium, and toward a commissure of a mitral valve of the heart. A commissural helix is implanted at the commissure by advancing the commissural helix out of the surrounding-sheath and through the commissure into a left ventricle of the heart, such that the commissural helix wraps around at least some chordae tendineae at the commissure and facilitates sealing of the commissure. Subsequently to the implantation of the commissural helix, the surrounding-sheath is extracted from the heart. Other embodiments are also described.
1. A method, for use at a mitral valve of a heart of a subject, the method comprising:
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;
advancing a distal end of a surrounding-sheath out of a distal end of the transluminal sheath, into the left atrium, and toward a commissure of the mitral valve;
at the commissure, advancing a distal end of a delivery lumen and an anchor out of the distal end of the surrounding-sheath, into a left ventricle of the subject, and, while the distal end of the delivery lumen is in the left ventricle, helically implanting the anchor by wrapping the anchor around at least some chordae tendineae that are at the commissure;
subsequently to helically implanting the anchor, extracting the surrounding-sheath and the delivery lumen from the heart; and
subsequently, implanting a prosthetic valve in the mitral valve such that the anchor facilitates anchoring of the prosthetic valve and sealing of the commissure.
2. The method according to claim 1 , wherein the anchor is a first anchor and the commissure is a first commissure of the mitral valve, wherein the method further comprises, subsequently to helically implanting the first anchor at the first commissure, helically implanting a second anchor by wrapping the second anchor around at least some chordae tendineae that are at a second commissure of the mitral valve, and wherein implanting the prosthetic valve in the mitral valve comprises implanting the prosthetic valve in the mitral valve such that the first and second anchors facilitate anchoring of the prosthetic valve and sealing of the first and second commissures.
3. The method according to claim 2 , wherein:
the surrounding-sheath is a first surrounding-sheath,
the delivery lumen is a first delivery lumen,
the method further comprises advancing a distal end of a second surrounding-sheath out of the distal end of the transluminal sheath, into the left atrium, and toward the second commissure, and
helically implanting the second anchor comprises, at the second commissure, advancing a distal end of a second delivery lumen out of the distal end of the second surrounding-sheath, into the left ventricle.
4. The method according to claim 1 , wherein the is conical, having a wider end and a narrower end, and wherein helically implanting the anchor comprises helically implanting the anchor that is conical, having a wider end and a narrower end.
5. The method according to claim 4 , wherein helically implanting the anchor comprises helically implanting the anchor such that the wider end is upstream of the narrower end.
6. The method according to claim 1 , further comprising, prior to the advancing of the distal end of the surrounding-sheath, advancing a guide member to the commissure, and wherein advancing the distal end of the surrounding-sheath comprises sliding the distal end of the surrounding-sheath around the guide member.
7. The method according to claim 1 , wherein helically implanting the anchor comprises positioning the anchor such that a wider end of the anchor is upstream of a narrower end of the anchor.
8. The method according to claim 1 , wherein helically implanting the anchor comprises positioning the anchor such that a curved portion of the anchor having a greater radius of curvature is upstream of a curved portion of the anchor having a smaller radius of curvature.
9. The method according to claim 1 , further comprising, subsequently to the extracting of the surrounding-sheath, advancing a guide wire through the transluminal sheath.
10. The method according to claim 9 , further comprising, subsequently to the advancing of the guide wire, advancing the prosthetic valve along the guide wire.