Implant for rotation-based anchoring

Abstract

Apparatus and methods are provided for use with a prosthetic valve that is designated for implantation at a patient's native heart valve, including a valve ring having a plurality of ring segments, each of the segments being hingedly coupled to an adjacent segment at a pivot joint. The valve ring is placed adjacent to a surface of the native heart valve, the prosthetic valve having been coupled to the valve ring. In an expanded state thereof, the valve ring defines a ring, all of the pivot joints being disposed in a plane that is perpendicular to a longitudinal axis of the ring. The valve ring is foldable into a shape that has a generally circular cross-section that defines and surrounds at least in part a central lumen, by folding the segments with respect to each other, at the pivot joints. Other embodiments are also described.

1 - 17 . (canceled) 
     
     
         18 . Apparatus for implantation at a native valve of a patient, the apparatus having an upstream end and a downstream end and a longitudinal axis therebetween, and comprising:
 a plurality of components, the plurality of components comprising an annular element;   a plurality of prosthetic valve leaflets couplable to an inner perimeter of the annular element; and   a plurality of anchors distributed circumferentially around the annular element, each anchor having:
 a first portion attached to the annular element, and 
 a second portion that:
 extends from the first portion in a circumferential direction around the longitudinal axis of the apparatus, 
 is configured to grasp chordae tendineae of the native valve, and 
 is disposed further, in the circumferential direction, around the longitudinal axis of the apparatus than is any point of attachment of the anchor to the annular element, 
 
   
       wherein at least one component of the plurality of components is disposed downstream from the second portion of the plurality of anchors. 
     
     
         19 . The apparatus according to  claim 18 , wherein each anchor of the plurality of anchors is configured to grasp chordae tendineae of the native valve by rotation of the apparatus around the longitudinal axis of the apparatus. 
     
     
         20 . The apparatus according to  claim 18 , wherein the apparatus (i) has a collapsed state for transluminal delivery to the valve, and (ii) is intracorporeally expandable. 
     
     
         21 . The apparatus according to  claim 20 , wherein:
 in the collapsed state, at least the annular element is collapsed,   the apparatus is intracorporeally expandable by expanding at least the annular element into an expanded state thereof, and   the plurality of anchors are configured to grasp the chordae tendineae by rotation of the apparatus around the longitudinal axis of the apparatus while the annular element is in the expanded state thereof.   
     
     
         22 . The apparatus according to  claim 18 , wherein the annular element is configured to be placed at a ventricular surface of the native valve. 
     
     
         23 . The apparatus according to  claim 18 , wherein the at least one component comprises a lower skirt, coupled to the annular element, and configured to rest against a ventricular surface of the native valve. 
     
     
         24 . The apparatus according to  claim 18 , wherein the plurality of components comprises an upper skirt, coupled to the annular element, and configured to rest against an atrial portion of the native valve. 
     
     
         25 . The apparatus according to  claim 24 , wherein the upper skirt comprises an upper skirt fabric coupled to an upper skirt frame. 
     
     
         26 . The apparatus according to  claim 24 , further comprising a lower skirt, coupled to the annular element, and configured to rest against a ventricular surface of the native valve. 
     
     
         27 . The apparatus according to  claim 26 , wherein the native valve has native leaflets, and the lower skirt is configured to push the native leaflets radially outward. 
     
     
         28 . Apparatus for implantation at a native valve of a patient, the apparatus comprising a prosthetic valve having (i) a collapsed state for transluminal delivery to the valve, and (ii) an expanded state, and comprising:
 an annular element;   a plurality of prosthetic leaflets, couplable to an inner perimeter of the annular element; and   a plurality of anchors distributed circumferentially around the annular element, each anchor:
 having a first end coupled to the annular element, and 
 in the expanded state, extending from the first end radially away from the annular element and circumferentially alongside a respective portion of the annular element so as to define a space between the anchor and the annular element. 
   
     
     
         29 . The apparatus according to  claim 28 , wherein the anchors are arranged such that the space is dimensioned to receive one or more chordae tendineae of the native valve. 
     
     
         30 . The apparatus according to  claim 28 , wherein the plurality of anchors comprises 4-8 anchors. 
     
     
         31 . The apparatus according to  claim 28 , wherein each anchor is prong-shaped. 
     
     
         32 . The apparatus according to  claim 28 , further comprising an upper skirt, coupled to the annular element, and configured to rest against an atrial portion of the native valve. 
     
     
         33 . The apparatus according to  claim 32 , wherein the upper skirt comprises an upper skirt fabric coupled to an upper skirt frame. 
     
     
         34 . The apparatus according to  claim 32 , further comprising a lower skirt, coupled to the annular element, and configured to rest against a ventricular surface of the native valve. 
     
     
         35 . The apparatus according to  claim 34 , wherein the native valve has native leaflets, and the lower skirt is configured to push radially the native leaflets. 
     
     
         36 . The apparatus according to  claim 28 , wherein each anchor is shaped at a second end of the anchor to provide an opening into the space through which the one or more chordae tendineae are movable. 
     
     
         37 . The apparatus according to  claim 28 , wherein each anchor is shaped at the second end of the anchor to curve radially away from the annular element. 
     
     
         38 . The apparatus according to  claim 36 , wherein each anchor is shaped and positioned such that the opening is circumferentially alongside the annular element. 
     
     
         39 . The apparatus according to  claim 28 , wherein the annular element is configured to he placed at a ventricular surface of the native valve. 
     
     
         40 . The apparatus according to  claim 28 , wherein the annular element is dimensioned, and the anchors are disposed with respect to the annular element, such that when the annular element is at the native valve and in the expanded state, rotation of the annular element with respect to the native valve gathers the one or more chordae tendineae into the space.