CN117297843B

CN117297843B - Take-up device, take-up system and implant

Info

Publication number: CN117297843B
Application number: CN202311597836.XA
Authority: CN
Inventors: 匡经旭; 张庭超; 郭荣辉
Original assignee: Hangzhou Valgen Medtech Co Ltd
Current assignee: Hangzhou Valgen Medtech Co Ltd
Priority date: 2023-11-28
Filing date: 2023-11-28
Publication date: 2024-03-15
Anticipated expiration: 2043-11-28
Also published as: CN117297843A

Abstract

The application provides a wire collecting device, a wire collecting system and an implant. The wire winding device comprises a shell with an inner cavity and a wire winding component at least partially accommodated in the inner cavity. The inner surface of the shell is provided with a stop block. The winding assembly is rotatable relative to the housing. The winding assembly comprises a winding piece, a locking block and an elastic piece. The wire winding is configured for winding a flexible wire. The elastic piece is configured to provide a force to the locking block to enable the locking block to abut against the stop block so as to limit the rotation of the winding assembly relative to the shell. The locking block is configured to be radially movable relative to the wire winding member under the influence of an external force to be out of the restriction of the stopper. In the wire winding device, the wire winding system and the implant of the embodiment of the application, when the locking block is abutted with the stop block to limit the rotation of the wire winding assembly, the wire winding device is in a locking state; when the locking block is separated from the limit of the stop block, the wire collecting device is in an unlocking state, and the wire winding assembly can be driven to rotate at the moment.

Description

Take-up device, take-up system and implant

Technical Field

The application relates to the field of medical equipment, in particular to a wire collecting device, a wire collecting system and an implant.

Background

Valve dilation is one of the most common causes of mitral and tricuspid valve, often resulting in mitral and tricuspid valve insufficiency and regurgitation of blood. Annuloplasty is performed on the dilated annulus to reduce the mitral or tricuspid valve orifice area by contracting the annulus so that the leaflets can conform to each other during ventricular contraction, achieving reduced or eliminated regurgitation.

For some annuloplasty applications, an annuloplasty structure is implanted over the annulus, and the length of the flexible wire of the annuloplasty structure is adjusted (e.g., the flexible wire is tightened) to reduce the circumference of the annulus to treat regurgitation. The length of the flexible wire is adjusted and then locked by a device to maintain the effect of narrowing the annulus.

Disclosure of Invention

The embodiment of the application provides a take-up device. The wire winding device comprises a shell with an inner cavity and a wire winding component at least partially accommodated in the inner cavity. The inner surface of the shell is provided with a stop block. The winding assembly is rotatable relative to the housing. The winding assembly comprises a winding piece, a locking block and an elastic piece. The wire winding is configured for winding a flexible wire. The spring is configured to provide a force to the locking block to urge the locking block into abutment with the stop block to limit rotation of the winding assembly relative to the housing. The locking block is configured to be radially movable relative to the wire winding member under the influence of external force to be out of the restriction of the stopper.

The embodiment of the application also provides a wire collecting system. The wire collecting system comprises a conveying device and the wire collecting device. The conveying device comprises an outer tube, an inner tube movably penetrating the outer tube and an elongated rod movably penetrating the inner tube. The distal end of the outer tube is connected to the housing and is relatively locked, and the distal end of the inner tube is connected to the wire winding member and is relatively locked. Wherein the outer tube is configured to limit rotation of the housing, the elongate rod is configured to provide an external force to the locking block to move the locking block radially relative to the wire winding member out of the limit of the stop block, and the inner tube is configured to drive rotation of the wire winding assembly relative to the housing.

Embodiments of the present application also provide an implant. The implant includes a flexible wire, a plurality of anchors, and the wire takeup device described above. The flexible wire connects the plurality of anchors and the take-up device. Each of the anchors is configured to anchor to tissue. The flexible wire is configured to adjust a spacing of the plurality of anchors. The wire takeup device is configured to adjust a length of the flexible wire and lock the length of the flexible wire.

In the wire winding device, the wire winding system and the implant of the embodiment of the application, when the elastic piece provides an acting force for the locking block to enable the locking block to be abutted with the stop block so as to limit the rotation of the wire winding assembly, the wire winding device is in a locking state; when the locking block moves radially relative to the winding piece under the action of external force and is out of the limit of the stop block, the wire collecting device is in an unlocking state, and the winding assembly can be driven to rotate clockwise or anticlockwise relative to the shell. Therefore, after the flexible wire is connected to the wire winding device, the locking block is separated from the limit of the stop block by applying force, and the flexible wire can be wound on the wire winding member by driving the wire winding assembly to rotate relative to the shell. When the flexible wire is adjusted to a proper length, the locking block is restored to be in contact with the stop block to limit the rotation of the winding assembly relative to the shell, and at the moment, the flexible wire is locked by the wire collecting device.

Drawings

In order to more clearly describe the technical solutions in the embodiments of the present application or in the background art, the drawings used in the embodiments of the present application will be described below. It will be apparent to those of ordinary skill in the art that the drawings in the following description are of some embodiments of the present application and that other drawings may be derived from these drawings without the exercise of inventive effort.

Fig. 1 is a schematic perspective view of a wire winding device according to an embodiment of the present disclosure;

FIG. 2 is a schematic view of the structure of an implant (with flexible wires tightened) according to an embodiment of the present application;

FIG. 3 is a schematic perspective view of an anchor according to an embodiment of the present application;

FIG. 4 is a schematic perspective view of an anchor according to another embodiment of the present application;

FIG. 5 is a schematic illustration of the attachment of the anchor of FIG. 3 to a flexible wire;

FIG. 6 is a schematic view of the structure of an implant (with flexible wires tightened) according to another embodiment of the present application;

FIG. 7 is a schematic illustration of the attachment of a flexible wire to a delivery member according to one embodiment of the present application;

fig. 8 is an exploded view of the wire takeup device of fig. 1;

FIG. 9 is another schematic view of the upper housing of FIG. 8;

FIG. 10 is a front view of a take-up system according to an embodiment of the present application;

fig. 11 is a cross-sectional view of the wire takeup system (the wire takeup device is in a locked state) in fig. 10;

fig. 12 is a cross-sectional view of the wire takeup device of fig. 1 in a locked state;

FIG. 13 is a schematic perspective view of the coil assembly of FIG. 8;

FIG. 14 is a schematic view of the lock block abutting the stop block;

fig. 15 is a cross-sectional view of the wire takeup system (the wire takeup device is in an unlocked state) in fig. 10;

Fig. 16 is a cross-sectional view of the wire takeup device of fig. 1 in an unlocked state;

fig. 17 is another perspective view of the winding assembly of fig. 8;

FIG. 18 is a schematic view of the lock block out of the limit of the stop block;

fig. 19 is another cross-sectional view of the wire takeup system of fig. 10 (the wire takeup device is in an unlocked state);

FIG. 20 is a schematic perspective view of a locking block according to an embodiment of the present application;

fig. 21 is an exploded view of a wire takeup device according to another embodiment of the present application;

fig. 22 is a cross-sectional view of the wire takeup device (in a locked state) and the delivery device of fig. 21;

fig. 23 is a schematic perspective view of the winding assembly of fig. 21;

fig. 24 is a cross-sectional view of the wire takeup device (in an unlocked state) and the conveying device in fig. 21;

fig. 25 is another perspective view of the winding assembly of fig. 21;

fig. 26 is an exploded view of a wire takeup device according to yet another embodiment of the present application;

fig. 27 is a cross-sectional view of the wire takeup device (in a locked state) and the delivery device of fig. 26;

fig. 28 is a schematic perspective view of the winding assembly of fig. 26;

fig. 29 is a cross-sectional view of the wire takeup device (in an unlocked state) and the conveying device in fig. 26;

fig. 30 is another perspective view of the winding assembly of fig. 26;

FIG. 31 is a schematic illustration of the attachment of the wire takeup device of FIG. 1 to a flexible elongated member;

FIG. 32 is a schematic view of the wire takeup device of FIG. 1 after the flexible wire is wound around the wire winding member;

FIG. 33 is a schematic perspective view of a conveying device according to an embodiment of the present application;

fig. 34-36 are schematic views of a procedure for applying a wire-rewinding device to mitral annuloplasty according to an embodiment of the present application.

Detailed Description

The following description of the embodiments of the present application will be made clearly and fully with reference to the accompanying drawings, in which it is evident that the embodiments described are only some, but not all, of the embodiments of the present application. All other embodiments, based on the embodiments herein, which would be apparent to one of ordinary skill in the art without undue burden are within the scope of the present application.

The term "proximal" and "distal" are defined herein as terms commonly used in the art of interventional medical devices. Specifically, "distal" refers to the end that is distal from the operator during a surgical procedure, and "proximal" refers to the end that is proximal to the operator during a surgical procedure. Axial refers to the direction parallel to the center line of the distal and proximal ends of the instrument or component, radial refers to the direction perpendicular to the axial direction and the radius or diameter of the instrument or component, and circumferential refers to the direction around the axial direction. It is noted that the term "end" as used in the terms of "proximal", "distal", "one end", "other end", "terminal", "both ends", "free end", etc., is not limited to a tip, end point or end face, but includes a location on an element to which a tip, end point or end face belongs that extends an axial distance and/or a radial distance from the tip, end point or end face. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used in the description of the invention herein is for the purpose of describing particular embodiments only and is not intended to be limiting.

In the description of the present application, it should be noted that, unless explicitly specified and limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be either fixedly connected, movably connected, detachably connected, or integrally connected, for example; can be directly connected or indirectly connected through an intermediate medium, and can be communicated with the inside of two elements or the interaction relationship of the two elements. In this application, fixed connection includes integrated into one piece, welding, riveting, bonding, threaded connection, joint and other can realize two component relative fixed connected mode.

References to directional terms in the embodiments of the present application, such as "upper", "lower", "left", "right", "inner", "outer", etc., are merely with reference to the directions of the drawings, and thus the directional terms used are used to better and more clearly describe and understand the embodiments of the present application, rather than to indicate or imply that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus should not be construed as limiting the embodiments of the present application. "plurality" means at least two.

In the present application embodiments, the terms "first," "second," "third," and the like are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first", "a second", or a third "may explicitly or implicitly include one or more such feature.

The present application provides many different embodiments or examples, and it is to be understood that the specific embodiments described herein are merely illustrative of the application and not limiting of the application. It should be further noted that, for convenience of description, only the portions relevant to the present application are shown in the drawings. The present application will be described in detail below with reference to the accompanying drawings in conjunction with embodiments.

Referring to fig. 1 and 2, a wire rewinding device 10 is provided in an embodiment of the present application. The wire takeup device 10 may be disposed in an implant 100 for annuloplasty. Implant 100 includes flexible wire 30, a plurality of anchors 50, and wire takeup device 10. The flexible wire 30 connects a plurality of anchors 50 to the wire takeup device 10. Each anchor 50 is configured to anchor to tissue, which may be heart tissue such as an annulus or a ventricular wall. The flexible wire 30 is configured to adjust the spacing of the anchors 50 relative to one another. The wire takeup device 10 is configured to adjust the length of the flexible wire 30 and lock the length of the flexible wire 30. The wire takeup device 10 may also be applied to a chordae tendineae prosthesis where the flexible wire 30 is employed as an artificial chordae tendineae connecting the valve leaflet with the papillary muscles/ventricle wall, the wire takeup device 10 adjusting the length of the flexible wire 30 and locking the length of the flexible wire 30 to adjust and fix the length of the artificial chordae tendineae.

In this application, flexible wire 30 may be a flexible wire such as a wire, filament, rope, strip, ribbon, or the like. The radial cross-sectional shape of the flexible wire 30 may be circular, oblate, rectangular, square, or other shapes, etc., as not limited in this application. The flexible wire 30 may be made of a biocompatible metal material and/or a polymer material, such as stainless steel 316L, tungsten, tantalum, nickel titanium, polyethylene, polyamide, polypropylene, polyurethane, etc. Illustratively, the flexible wire 30 is an elongated wire that may be woven from a plurality of metal filaments. The flexible wire 30 is developable under DSA (Digital subtraction angiography ) equipment.

The following specifically describes an example of the application of the wire takeup device 10 to annuloplasty.

In annuloplasty, after the plurality of anchors 50 connected by the flexible wire 30 are implanted in the annulus tissue, the wire takeup device 10 adjusts the spacing of the plurality of anchors 50 by tightening or loosening the flexible wire 30 (i.e., adjusting the length of the flexible wire 30), thereby adjusting the size of the annulus. The wire takeup device 10 is capable of locking the length of the flexible wire 30 to maintain the adjusted size of the annulus. Tightening of the flexible wire 30 by the retractor 10 reduces the spacing of the plurality of anchors 50, thereby reducing the size of the patient's annulus for the purpose of reducing regurgitation in blood. After the desired effect of narrowing the annulus is achieved, the wire takeup device 10 can lock the length of the flexible wire 30, thereby maintaining the effect of narrowing the annulus. In the event that the flexible wire 30 is too tightly packed (i.e., the spacing between the anchors 50 is too small), the wire takeup device 10 may loosen the flexible wire 30 and readjust the spacing between the anchors 50 until the desired effect is achieved by sizing the annulus.

It will be appreciated that the plurality of anchors 50 connected by flexible wire 30 may be anchored to heart tissue such as the mitral valve annulus, tricuspid valve annulus, left ventricular wall, or right ventricular wall. When the implant 100 is implanted in the annulus, the annulus is contracted directly by tightening the flexible wire 30. When implant 100 is implanted in the wall of a ventricle below the annulus, such as the wall of the ventricle 0.5cm-2cm below the annulus, the reduction in volume of the ventricle can also be achieved by constricting the flexible wire 30 to constrict the ventricle. It should be noted that the volume reduction of the left ventricle can also treat ischemic heart failure. Implant 100 is specifically described below using tissue as an annulus.

Referring to fig. 3-5, in some embodiments, anchor 50 includes a tissue-engaging element 52, a head 54, and a connecting structure 56. Head 54 is connected to the proximal end of tissue-engaging element 52. Tissue-engaging element 52 is configured to anchor into tissue. The head 54 is configured to be coupled to a driving device. The connecting structure 56 is rotatably sleeved on the head 54 or on a proximal portion of the tissue-engaging element 52. The connection structure 56 is provided with a connection hole 560. The connecting hole 560 is configured for the flexible wire 30 to pass through. It will be appreciated that tissue-engaging element 52 has a distal tip 522 for ease of penetration of tissue. The anchor 50 is connected by a head 54 to a driving device that is capable of driving the tissue-engaging element 52 to anchor into tissue. The anchor 50 is connected to the flexible wire 30 through the connecting hole 560 of the connecting structure 56. The connecting structure 56 is capable of 360 ° rotation about the proximal portion of the head 54 or tissue-engaging element 52. When the driving head 54 and the tissue engagement element 52 are rotated, the connection structure 56 is controlled not to rotate together, so that the flexible wire 30 connected to the connection structure 56 is prevented from being wound around the tissue engagement element 52.

Referring to fig. 2 and 5, in some embodiments, a crimp tube 31 is provided at the distal end of the flexible wire 30. The crimp tube 31 is located distally of the connecting hole 560 of the first (in order of implantation sequence) anchor 50. The crimp tube 31 is constrained through the attachment aperture 560 of the first anchor 50. Illustratively, the two free ends of the flexible wire 30 pass through the connecting hole 560 of the first anchor 50 from the proximal to the distal, and then pass through the crimp tube 31, and the two free ends of the flexible wire 30 (i.e., the distal ends of the flexible wire 30) are fixedly connected to the crimp tube 31 by crimping. The crimp tubing 31 may be covered with a protective film 310, with the protective film 310 being attached to the attachment structure 56 by stitching to attach the crimp tubing 31 to the attachment structure 56 of the first anchor 50. The protective film 310 may be a biocompatible film, and the material may be PET (Polyethylene terephthalate ). Wherein, in order to restrict the pressure pipe 31 from passing through the connection hole 560, the maximum outer diameter of the pressure pipe 31 may be set to be greater than the minimum inner diameter of the connection hole 560.

Referring to fig. 6, in some embodiments, the implant 100 further includes at least one spacer 70. The spacer 70 is movably connected to the flexible wire 30. The spacer 70 is disposed between two adjacent anchors 50. It will be appreciated that the spacer 70 prevents the flexible wire 30 from being too tightly packed resulting in too short a distance between two adjacent anchors 50 to affect the effectiveness of the narrowing of the annulus. At the same time, the spacer 70 can play a role of buffering, disperses the tightening force applied to the anchor 50, and ensures the stable implantation of the anchor 50. Wherein the spacer 70 is a cylindrical member having a certain length and is made of a biocompatible material. The spacer 70 may be covered with a coating to reduce the risk of damage to heart tissue by the spacer 70 and to increase biocompatibility.

Alternatively, a spacer 70 may be provided between any two adjacent anchors 50 of the plurality of anchors 50, i.e., the anchors 50 are staggered with respect to the spacer 70. Of course, it is also possible to provide one spacer 70 for each of two or more anchors 50, that is, a spacer 70 is provided between two anchors 50 that are partially adjacent, and no spacer 70 is provided between two anchors 50 that are partially adjacent, which is not limited in this application.

Referring to fig. 7, in some embodiments, a delivery member 200 is attached to the proximal end of flexible wire 30. As previously described, the distal end of flexible wire 30 is connected to first anchor 50. The flexible wire 30, delivery member 200, is delivered into the patient with the first anchor 50, and the proximal end of the delivery member 200 extends outside the patient. Anchors 50, spacers 70, wire takeup device 10, etc. are delivered to flexible wire 30 by delivery member 200. After the wire takeup device 10 is stably connected to the flexible wire 30, the delivery member 200 is disconnected from the flexible wire 30 and withdrawn from the patient. Thus, the flexible wire 30 can be selected to have a proper implantation length, the flexible wire 30 does not need to be cut in the body, the falling of particles on the wire is avoided, and the operation is safer.

In this application, the delivery member 200 can be a flexible wire such as a wire, filament, rope, strip, ribbon, or the like. The radial cross-sectional shape of the delivery member 200 can be circular, oblate, rectangular, square, or other shapes, etc., as not limited in this application. The delivery member 200 can be made of biocompatible metallic and/or polymeric materials such as stainless steel 316L, tungsten, tantalum, nitinol, polyethylene, polyamide, polypropylene, polyurethane, etc. Illustratively, the delivery member 200 is an elongate wire, such as a polymer wire.

In the example of fig. 7, the proximal end of flexible wire 30 is connected to the distal end of delivery member 200 in a U-shape. Thus, pulling a free end of the delivery member 200 outside the body can separate the delivery member 200 from the flexible wire 30, and the operation is simple. In other embodiments, the delivery member 200 may be detachably connected to the flexible wire 30 by a threaded connection, a snap connection, or the like, which will not be described in detail.

In the example of fig. 5, the length of the flexible wire 30 may also be sufficiently long. When flexible wire 30 is delivered into a patient with first anchor 50, the proximal end of flexible wire 30 can extend outside of the patient to facilitate donning of anchors 50, spacer 70, wire takeup device 10, and the like. After the wire takeup device 10 is stably connected to the flexible wire 30, the excess portion of the flexible wire 30 may be cut off by a cutter.

Referring to fig. 8, 9, 11 and 12, in some embodiments, the wire takeup device 10 includes a housing 12 having an inner cavity 122 and a wire winding assembly 14 at least partially received in the inner cavity 122. The inner surface of the housing 12 is provided with a stop 16. The wire winding assembly 14 is rotatable relative to the housing 12. The winding assembly 14 includes a winding member 142, a locking block 144, and an elastic member 146. The wire wrap 142 is configured for winding the flexible wire 30. The resilient member 146 is configured to provide a force to the locking block 144 to urge the locking block 144 into abutment with the stop block 16 to limit rotation of the wire winding assembly 14 relative to the housing 12. The locking block 144 is configured to be radially movable relative to the wire wrap 142 under the influence of an external force to disengage the limit of the stop block 16.

It will be appreciated that the wire takeup device 10 is in a locked state when the resilient member 146 provides a force to the locking block 144 such that the locking block 144 abuts the stop block 16 to limit rotation of the wire winding assembly 14; when the locking block 144 moves radially relative to the winding member 142 under the action of external force and is out of the limit of the stop block 16, the wire winding device 10 is in an unlocked state, and the winding assembly 14 can be driven to rotate clockwise or counterclockwise relative to the housing 12. Accordingly, after the flexible wire 30 is coupled to the wire takeup device 10 (see fig. 31), the locking block 144 is forced out of engagement with the stop block 16, and the flexible wire 30 can be wound onto the wire winding member 142 by rotating the wire winding assembly 14 relative to the housing 12 (see fig. 32). When the flexible wire 30 is adjusted to the proper length, the locking block 144 is brought back into abutment with the stop block 16 to limit rotation of the winding assembly 14 relative to the housing 12, at which point the flexible wire 30 is locked by the wire takeup device 10.

It should be noted that, the locking block 144 abuts against the stop block 16, that is, the locking block 144 abuts against the stop block 16, and the locking block 144 is blocked by the stop block 16 and cannot rotate circumferentially, so that the winding assembly 14 is limited to rotate relative to the housing 12. The locking block 144 is disengaged from the stopper 16, which means that the locking block 144 is separated from the stopper 16, the locking block 144 is rotatable circumferentially without being blocked by the stopper 16, and thus the winding assembly 14 is rotatable with respect to the housing 12. The stop block 16 is fixedly disposed on the inner surface of the housing 12. The shell 12 and the stop block 16 can be integrally formed and relatively fixed; the housing 12 and stop 16 may also be formed separately and then secured relative to each other by welding, riveting, adhesive or other means of attachment.

The flexible wire 30 is wound at least two turns, preferably at least three turns, around the wire winding member 142. In this way, there is a friction force between the flexible wire 30 and the winding member 142, and there is a friction force between the plurality of turns of flexible wire 30 wound around the winding member 142 due to the overlapping. The friction force can counteract the tensile force generated by the activity of the valve leaflet, so that the flexible wire 30 is not pulled by the tensile force generated by the activity of the valve leaflet, and the wire collecting device 10 is stably connected with the flexible wire 30. In general, the flexible wire 30 is wound around the winding member 142 for a plurality of turns, the friction force between the flexible wire 30 wound around the plurality of turns is greater, the locking force of the winding device 10 to the flexible wire 30 is stronger, and the fatigue performance of the flexible wire 30 is better.

Referring to fig. 9, 21 and 26, in some embodiments, the winding member 142 is provided with a sliding slot 1420 along a radial direction thereof, and the locking block 144 is movably disposed in the sliding slot 1420. In this way, the lock block 144 can move radially in the slide groove 1420 relative to the wire winding member 142 to change the relative position of the lock block 144 and the stopper 16, so that the lock block 144 abuts against the stopper 16 or the lock block 144 is released from the restriction of the stopper 16, thereby switching the locked state and the unlocked state of the wire winding device 10.

Referring to fig. 11, 15, 22, 24, 27 and 29, in some embodiments, the housing 12 is further provided with a proximal port 124 that communicates with the lumen 122. The wire winding 142 includes a spool 1422, a connection block 1424, and a drive section 1426. Spool 1422 is configured for winding flexible wire 30. The connection block 1424 defines a slide channel 1420. The drive section 1426 at least partially protrudes from the proximal port 124. The drive section 1426 is provided with a drive channel 14260 which communicates with the slide channel 1420.

It will be appreciated that the spool 1422, the connector block 1424, and the locking block 144 are integrally received in the interior cavity 122 of the housing 12, with the drive segment 1426 extending at least partially from the proximal port 124 of the housing 12. The freedom of the locking block 144 in the axial direction of the winding member 142 is limited by the housing 12 and the connection block 1424 together, i.e., the locking block 144 is limited by the housing 12 and the connection block 1424 together and cannot move axially relative to the winding member 142. The locking block 144 is located in the sliding slot 1420 and can move radially relative to the winding member 142, and the freedom in other directions is limited by the connecting seat 1424. The drive channel 14260 of the drive section 1426 is configured for passage of an elongate rod 26, and the elongate rod 26 can apply an external force to the locking block 144 to move the locking block 144 radially in the slide channel 1420 relative to the spool 142. The spool 1422, the connection mount 1424, and the drive section 1426 may be integrally formed and relatively fixed; the spool 1422, the connector block 1424, and the drive section 1426 may also be formed separately and then secured relative to one another by welding, riveting, adhesive bonding, or other means of attachment.

When the wire winding device 10 is in the locked state, the elastic member 146 is in the initial state, the elastic member 146 provides a force to the locking block 144 to make the locking block 144 abut against the stop block 16, and the stop block 16 limits the circumferential rotation of the locking member, that is, the circumferential rotation of the wire winding member 142, because the locking block 144 is located in the sliding groove 1420 of the wire winding member 142. The elongated rod 26 passes through the drive passage 14260 of the drive section 1426 and applies an external force to the locking block 144 in the slide channel 1420 to urge the locking block 144 to move radially outwardly relative to the winding member 142 out of engagement with the stop block 16, at which time the winding apparatus 10 is transitioned to the unlocked state and the winding assembly 14 is bi-directionally rotatable relative to the housing 12. When the locking block 144 moves radially outwardly in the sliding slot 1420, the resilient member 146 is deformed by the squeezing action of the locking block 144. When the wire takeup device 10 needs to be locked, the elongate rod 26 is removed, and the resilient member 146 urges the locking block 144 radially inwardly to re-abut the stop block 16 due to its resilient return shape (i.e., return to the original state), and the wire takeup device 10 returns to the locked state.

Referring to fig. 9, 21 and 26, in some embodiments, the connection seat 1424 includes a support platform 14242 and two protrusions 14244 fixedly disposed on the support platform 14242. The two projections 14244 are spaced apart to form a runner 1420. Thus, the support stand 14242 can provide support for the locking block 144, with two spaced apart projections 14244 confining the locking block 144 to the slide channel 1420. In this embodiment, the sliding groove 1420 is opened at both ends in the radial direction of the winding member 142, and the number of the locking blocks 144 may be two. In other embodiments, the number of locking blocks 144 may be one with one end of the sliding groove 1420 being open and the other end being closed along the radial direction of the wire winding member 142.

Further, referring to fig. 20, the locking block 144 includes a first portion 1441 and a second portion 1443 arranged in a radial direction of the wire winding member 142. The width of the second portion 1443 is smaller than the width of the first portion 1441 so that the locking block 144 forms a stop surface 1445. The winding member 142 further includes a stopper 1428 disposed in the chute 1420. After the second portion 1443 enters the sliding chute 1420, the limiting surface 1445 abuts the limiting block 1428 to limit the first portion 1441 from entering the sliding chute 1420. In this way, the engagement of stop surface 1445 with stop 1428 limits the distance that locking block 144 moves radially inward in slide channel 1420, ensuring that resilient member 146 can compress against locking block 144 to provide force to locking block 144. The spool 1422, the connection block 1424, the driving section 1426, and the stopper 1428 may be integrally formed and relatively fixed. Of course, the limiting block 1428 and the driving section 1426 may be integrally formed, the spool 1422 and the connecting seat 1424 may be respectively formed, and then the relative fixation may be achieved by welding, riveting, bonding or other connection methods; the limiting block 1428 and the connecting seat 1424 may be integrally formed, the spool 1422 and the driving section 1426 may be separately formed, and then be relatively fixed by welding, riveting, bonding or other connection methods.

Referring to fig. 20, in some embodiments, the locking block 144 includes a drive ramp 1447 and a sliding surface 1449, wherein an angle between the drive ramp 1447 and the sliding surface 1449 is greater than 0 degrees and less than 90 degrees, and wherein the drive ramp is inclined with respect to the central axis of the wire-wound member 142 and the drive ramp 1447 is closer to the central axis of the wire-wound member 142 from its proximal end to its distal end such that, when the elongate rod 26 moves axially downward, the drive ramp 1447 is pushed and a driving force is applied to the drive ramp 1447 that causes the locking block 144 to move radially outward, thereby pushing the locking block 144 to move radially outward with respect to the wire-wound member 142. Specifically, the sliding surface 1449 is a surface that contacts the support 14242 of the connection block 1424, and the lock block 144 moves radially via the sliding surface 1449. When the number of the locking blocks 144 is two, the driving slopes 1447 of the two locking blocks 144 are disposed opposite to each other.

Referring to fig. 12-14 and 16-18, in some embodiments, the locking block 144 includes a driving portion 1442 and a locking portion 1444. The locking portion 1444 protrudes proximally relative to the driving portion 1442 to form a relief position 1446. When the wire takeup device 10 is in the locked state, the locking portion 1444 abuts the stop block 16 to limit rotation of the wire winding assembly 14 relative to the housing 12. The stop block 16 can pass through the clear position 1446 when the wire takeup device 10 is in the unlocked state. Thus, the lock block 144 abuts the stopper 16 via the lock portion 1444 to restrict the rotation of the winding assembly 14. The relief position 1446 is designed such that a short distance of movement of the locking block 144 radially outward of the winding member 142 can disengage the locking block 144 from the limit of the stop block 16, thereby avoiding an increase in the overall size of the wire winding apparatus 10. After the locking block 144 is separated from the limit of the stop block 16, a part of the locking block 144 is still located in the sliding groove 1420, so that the problem that the wire collecting device 10 is recovered to the locking state due to the fact that the locking block 144 is difficult to smoothly enter the sliding groove 1420 after being separated from the sliding groove 1420 is avoided.

In some embodiments, the surfaces of the locking portions 1444 that abut the stop blocks 16 are substantially parallel to the central axis of the wire winding member 142. Thus, the stopper 16 has a good blocking effect on the locking portion 1444.

Referring to fig. 8 to 17, in some embodiments, the elastic member 146 includes a spring plate 146a. The elastic piece 146a includes a protruding portion 1462 and connection portions 1464 located on both sides of the protruding portion 1462. The connection portion 1464 is fixedly connected to the winding member 142. The protrusion 1462 protrudes inward in the radial direction of the wire winding member 142, and the protrusion 1462 may abut the locking block 144 and provide a force to the locking block 144 to abut the locking block 144 with the stopper 16. The entire elastic member 146 is disposed radially outward of the locking block 144. It can be appreciated that when the wire winding device 10 is in the locked state, the elastic piece 146a is in the initial state, and the protruding portion 1462 of the elastic piece 146a protrudes inward along the radial direction of the wire winding member 142 to abut against the locking block 144, so as to provide a force to the locking block 144 to abut against the stop block 16. When the wire takeup device 10 is unlocked, the locking block 144 is pushed by the elongated rod 26 to move outwards along the radial direction of the wire winding member 142, and the locking block 144 presses the protruding portion 1462 of the elastic sheet 146a to deform outwards along the radial direction of the wire winding member 142. When the elongate lever 26 is removed, the resilient piece 146a urges the locking block 144 radially inwardly to re-abut the stopper 16 due to its resilient recovery shape (i.e., the projection 1462 is recovered to an initial state protruding radially inwardly of the wire winding member 142), and the wire takeup device 10 is recovered to a locked state.

The spring plate 146a may fixedly connect the connection portion 1464 with the wire winding member 142 by the fixing pin 148. Illustratively, in the case where the number of the locking blocks 144 is two, the number of the elastic pieces 146a is correspondingly two. The connecting portions 1464 on two sides of each spring plate 146a are provided with mounting holes, and the two protrusions 14244 of the connecting seat 1424 are respectively provided with a fixing hole. The fixing pin 148 sequentially passes through the mounting holes on one side of the two elastic pieces 146a and the fixing hole of the connecting seat 1424, and the fixing pin 148 and the bump 14244 of the connecting seat 1424 can be fixedly connected in a welding manner, so that the elastic pieces 146a are fixed on the winding piece 142, that is, the elastic pieces 146a are fixedly connected with the winding piece 142 through the connecting portion 1464.

The spring plate 146a may be made of an elastic material, such as a shape memory alloy (ni—ti SMA (Nickel Titanium Shape Memory Alloys, nickel titanium based shape memory alloy), cu SMA (Cu-based Shape Memory Alloys, copper based shape memory alloy Cu SMA), fe SMA (iron based shape memory alloy, fe-based Shape Memory Alloys), etc.), stainless steel, etc. In one example, the elastic sheet 146a is made of nickel-titanium alloy and is shaped by heat treatment, and has super elasticity and good elastic performance.

Referring to fig. 21 to 30, in other embodiments, the elastic member 146 includes an elastic ring 146b surrounding the radially outer side of the locking block 144. In other words, the elastic ring 146b is sleeved on the winding member 142 and abuts against the locking block 144. It will be appreciated that the elastic ring 146b is disposed around the winding member 142 and abuts the locking block 144, and can provide a force to the locking block 144 to bring the locking block 144 into abutment with the stop block 16. Since the elastic ring 146b can be radially expanded, when the winding device 10 is unlocked, the locking block 144 is pushed by the elongated rod 26 to move outwards along the radial direction of the winding piece 142, and the locking block 144 presses the elastic ring 146b to deform outwards along the radial direction of the winding piece 142, that is, the elastic ring 146b is radially stretched, so that the radial dimension becomes larger. When the elongate rod 26 is removed, the resilient loop 146b, due to its resilient return shape (i.e. return to the radial dimension of the original state), urges the locking block 144 radially inwards into re-abutment with the stop block 16, and the wire takeup device 10 returns to the locked state. The elastic loop 146b does not need to be secured to the wire wrap 142 by fasteners such as the anchor pins 148.

Referring to fig. 21-25, in one example, the elastic loop 146b is an elastic helical coil. The elastic spiral coil can be made of shape memory alloy wire in spiral mode, and can be provided with two or more spiral coils, and the shape of the elastic spiral coil is similar to that of a spring. The shape memory alloy can be nickel-titanium based shape memory alloy Ni-Ti SMA, copper-based shape memory alloy Cu SMA, iron-based shape memory alloy Fe SMA, etc. In one example, the elastic spiral coil is made of nickel-titanium alloy wires through heat treatment and shaping, and has super elasticity and good elastic performance.

Referring to fig. 26 to 30, in another example, the elastic ring 146b is an elastic ring surrounding the radially outer side of the locking block 144. The elastic ring is annular, and the section of the elastic ring can be round, rectangular or other polygons. The elastic ring can be made of flexible and elastic materials, such as rubber, silica gel and the like. In this example, the locking block 144 may further be provided with a groove 1448, the groove 1448 being configured to place an elastic ring. In this way, the displacement of the elastic ring in the axial direction of the wire winding member 142 can be restricted.

Referring to fig. 31 and 32, in some embodiments, the housing 12 is provided with a first through hole 126. The winding member 142 is provided with a second through hole 1421. The first and second through holes 126, 1421 are configured to pass the flexible wire 30. The wire winding assembly 14 is configured to rotate relative to the housing 12 to wind the flexible wire 30 onto the wire winding member 142 or to unwind the flexible wire 30 from the wire winding member 142. It will be appreciated that flexible wire 30 is movable through first throughbore 126 of housing 12 and second throughbore 1421 of wire wrap 142 such that flexible wire 30 is connected to wire takeup device 10. Forward rotation of the wire winding assembly 14 relative to the housing 12 may wind the flexible wire 30 onto the wire winding member 142. Reverse rotation of the wire winding assembly 14 relative to the housing 12 may loosen the flexible wire 30 from the wire winding 142. In the present application, the rotational direction of the winding assembly 14 such that the flexible wire 30 is wound around the winding member 142 is defined as a forward rotation, and the rotational direction of the winding assembly 14 such that the flexible wire 30 is unwound from the winding member 142 is defined as a reverse rotation.

Illustratively, the housing 12 is provided with first through holes 126 on opposite sides thereof, such that the flexible wire 30 passes from the first through holes 126 on one side into the housing 12, through the second through holes 1421 of the wire-wound members 142, and out the first through holes 126 on the other side. In one example, the two first through holes 126 are symmetrically disposed about the central axis of the housing 12, and the central axes of the two first through holes 126 may be in the same plane as the central axis of the second through hole 1421. In this way, the rotatable wire winding assembly 14 makes the central axis of the second through hole 1421 substantially collinear with the central axes of the two first through holes 126, thereby facilitating smooth passage of the flexible wire 30 through the two first through holes 126 and the second through hole 1421. In other examples, the housing 12 may be provided with only one first through hole 126.

Referring to fig. 9, 21 and 26, in some embodiments, the housing 12 includes an upper housing 121, a lower housing 123 and two ring members 125. The upper case 121 is fixedly coupled with the lower case 123. The two ring members 125 are fixedly disposed at opposite sides of the lower housing 123, respectively, to form two first through holes 126. Specifically, the upper case 121 and the lower case 123 may be fixedly coupled by welding, bonding, screwing, or the like. Mounting holes are formed in two opposite sides of the lower housing 123, and two ring members 125 are fixedly mounted in the mounting holes, respectively. Rounded corners are provided on both the inner and outer sides of the ring 125 to reduce damage to the flexible wire 30.

Referring to fig. 10, 11, 15, 19, 22, 24, 27 and 29, the embodiment of the present application further provides a wire winding system 300. The wire rewinding system 300 includes the conveying device 20 and the wire rewinding device 10 of any of the above embodiments. The delivery device 20 includes an outer tube 22, an inner tube 24 movably mounted in the outer tube 22, and an elongate rod 26 movably mounted in the inner tube 24. The distal end of the outer tube 22 is connected to the housing 12 and is relatively rotationally fixed. The distal end of the inner tube 24 is connected to the wire wrap 142 and is relatively rotationally fixed. Wherein the outer tube 22 is configured to limit rotation of the housing 12, the elongate rod 26 is configured to provide an external force to the locking block 144 to move the locking block 144 radially relative to the wire wrap 142 out of the limit of the stop block 16, and the inner tube 24 is configured to drive rotation of the wire wrap assembly 14 relative to the housing 12.

It will be appreciated that after the plurality of anchors 50 connected by flexible wire 30 are anchored to the annulus, the retractor 10, which is connected to the distal end of the delivery device 20, is connected to the flexible wire 30, and then the distal push of the elongate rod 26 is forced against the locking block 144 to move the locking block 144 radially outwardly of the wire 142 out of the limit of the stop block 16, and the inner tube 24 is rotated to drive the wire assembly 14 relative to the housing 12 to rotate the flexible wire 30 around the wire 142 to tighten the flexible wire 30, reducing the spacing between the anchors 50 to reduce the size of the patient's annulus. After the desired effect of the annular constriction, rotation of the inner tube 24 is stopped to stop rotation of the wire winding assembly 14, and then the elongate rod 26 is retracted proximally, the resilient member 146, due to its resilient return shape, urges the locking block 144 radially inwardly of the wire winding member 142 into re-abutment with the stop block 16, thereby locking the flexible wire 30. During rotation of the inner tube 24, the outer tube 22 remains non-rotating to limit rotation of the housing 12.

Specifically, referring to fig. 8 and 33, the outer tube 22 includes an outer tube 222 and a connecting claw 224 fixedly disposed at a distal end of the outer tube 222. The housing 12 is correspondingly provided with a connecting slot 128 adapted to the connecting claw 224. The outer tube 22 and the housing 12 are connected and relatively locked against rotation by engagement of the connection pawl 224 with the connection slot 128. The number of connection claws 224 may be one or more, and the number of connection grooves 128 corresponds to the number of connection claws 224. In one example, the number of connection claws 224 is two, and the two connection claws 224 are fixedly connected to the distal end of the outer tube body 222 and are disposed opposite to each other. Correspondingly, the housing 12 is provided with two connecting grooves 128.

The distal end of the inner tube 24 is movably sleeved on the driving section 1426 of the winding member 142, and the inner tube 24 and the driving section 1426 are opposite to each other. In one example, the drive segment 1426 is axially provided with at least one flat surface, and correspondingly, the distal portion of the inner tube 24 is provided with at least one flat surface. The inner tube 24 and the second drive section 1426 are constrained from relative rotation by a plane. In another example, inner tube 24 and drive segment 1426 may be constrained from relative rotation by engagement of protrusions (not shown) and grooves (not shown).

The elongate rod 26 includes a body section 262 and a force applying section 264 coupled to the body section 262. Force applying section 264 is movable within drive channel 14260 of drive section 1426. The biasing segment 264 is moved distally to bias the locking block 144 to push the locking block 144 radially outwardly away from the housing 12, thereby allowing bi-directional rotation of the coil assembly 14 relative to the housing 12. When the wire takeup device 10 needs to be locked, the elongated rod 26 is removed and the locking block 144 is again in abutment with the stop block 16 under the drive of the elastic member 146.

Referring to fig. 19, in some embodiments, at least a proximal portion of the drive channel 14260 is internally threaded and the force applying segment 264 is correspondingly externally threaded. A first annular projection 240 is disposed within the interior cavity of the inner tube 24 and a second annular projection 260 is disposed within the elongate rod 26. Wherein the second annular projection 260 limits proximal movement of the first annular projection 240 after the distal end of the inner tube 24 is coupled to the drive segment 1426 and the force applying segment 264 of the elongate rod 26 is threadably coupled to the drive channel 14260. It will be appreciated that the force applying section 264 of the elongate rod 26 is threadably coupled to the drive channel 14260 of the drive section 1426 such that, on the one hand, the elongate rod 26 may be axially displaced relative to the drive channel 14260 by a screw drive and, on the other hand, the threaded connection may provide for a stable connection of the elongate rod 26 to the drive section 1426. While the second annular projection 260 limits proximal movement of the first annular projection 240 so that the inner tube 24 can remain connected to the connector.

Referring to fig. 34 to 36, the working principle of the suture receiving device 10 according to the embodiment of the present application will be described below with reference to the application of the suture receiving device 10 to mitral valve annuloplasty. Among the surgical paths of mitral annuloplasty are: femoral vein-inferior vena cava-right atrium-atrial septum-left atrium-mitral valve annulus.

The first step: a plurality of anchors 50 are implanted in the mitral valve annulus. Specifically, a sufficient number of anchors 50 are implanted in the mitral valve annulus, in sequence from the anterior triangle of the mitral valve, along the posterior annulus to the posterior triangle, or vice versa. Wherein the distal end of flexible wire 30 is connected to first anchor 50 and the proximal end of flexible wire 30 is connected to the distal end of delivery member 200 in a U-shape. The remaining anchors 50 are delivered to the flexible wire 30 by the delivery member 200 prior to implantation and are thereby articulated to the flexible wire 30. Two adjacent anchors 50 are provided with a spacer 70, and the spacing between adjacent anchors 50 is greater than the axial length of the spacer 70.

And a second step of: the crimping is achieved by the wire takeup device 10 tightening the flexible wire 30. Wherein, the wire collecting device 10 is connected to the distal end of the conveying device 20 in advance. Specifically, first, the proximal end of the delivery member 200 is sequentially passed through the first through hole 126, the second through hole 1421 on one side, the second through hole 1421 on the other side, and the first through hole 126 of the wire takeup device 10, and the wire takeup device 10 is delivered to the flexible wire 30 along the delivery member 200, and the wire takeup device 10 is close to the last anchor member 50. Rotation of the elongate rod 26 then causes the elongate rod 26 to move distally by a helical drive to apply a force to the locking block 144 to urge the locking portion 1444 radially outwardly of the wire wrap 142 to disengage the locking block 144 from the limit of the stop block 16, and the wire wrap assembly 14 can rotate bi-directionally relative to the housing 12. Next, the outer tube 22 is secured and the inner tube 24 and the elongate rod 26 are rotated clockwise to rotate the winding assembly 14 relative to the housing 12 to wind the flexible wire 30 onto the winding member 142. After the flexible wire 30 is wound at least two times around the wire winding member 142, the delivery member 200 is pulled to withdraw the delivery member 200 from the body. By ultrasonically observing the regurgitation of the mitral valve, if the regurgitation of the mitral valve has not been reduced to an ideal state, the inner tube 24 and the elongate rod 26 continue to be rotated clockwise, further tightening the flexible wire 30. If the flexible wire 30 is too tightly packed to cause stenosis of the mitral valve, the inner tube 24 and the elongate rod 26 are rotated counterclockwise, releasing a portion of the flexible wire 30. During the procedure, the clockwise rotation and counterclockwise rotation (if necessary) of the winding assembly 14 are controlled until a good crimping effect is achieved. Finally, the threaded connection of the elongate rod 26 to the drive segment 1426 is released, the locking block 144 moves radially inward into re-abutment with the stop block 16 under the drive of the resilient member 146, and the flexible wire 30 wound around the winding member 142 is in a locked state by friction, so that the length of the flexible wire 30 can be maintained unchanged.

It should be noted that, in the case of no conflict, the embodiments and features in the embodiments may be combined with each other, and any combination of features in different embodiments is also within the scope of protection of the present application, that is, the above-described embodiments may also be combined arbitrarily according to actual needs.

It should be noted that all the foregoing drawings are exemplary illustrations of the present application, and do not represent actual sizes of products. And the dimensional proportion relation between the components in the drawings is not limited to the actual products of the present application.

The above is only a part of embodiments and implementations of the present application, the protection scope of the present application is not limited thereto, and any person skilled in the art who is familiar with the technology disclosed in the present application can easily think about the changes or substitutions, and all the changes or substitutions should be covered in the protection scope of the present application. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.

Claims

1. A wire rewinding device, characterized by comprising:

a shell with an inner cavity, wherein a stop block is arranged on the inner surface of the shell;

and a wire winding assembly at least partially housed in the interior cavity, the wire winding assembly being rotatable relative to the housing; the winding assembly comprises a winding member, a locking block and an elastic member, wherein the winding member is configured for winding flexible wires, the elastic member is configured for providing force for the locking block to enable the locking block to abut against the stop block so as to limit the winding assembly to rotate relative to the shell, and the locking block is configured to be capable of radially moving relative to the winding member under the action of an elongated rod so as to be out of the limit of the stop block.

2. The wire takeup device of claim 1 wherein said wire winding member is radially provided with a chute, said lock block being movably located in said chute.

3. The wire takeup device of claim 2 wherein said housing is further provided with a proximal port communicating with said lumen, said wire winding member including a spool configured for winding said flexible wire, a connection block defining said chute, and a drive section at least partially extending from said proximal port, said drive section being provided with a drive channel communicating with said chute.

4. A wire rewinding device as claimed in claim 3, characterized in that said connection seat comprises a supporting table and two lugs fixedly arranged on said supporting table, two lugs being arranged at intervals to form said chute.

5. The wire takeup device of claim 4 wherein said locking block includes a first portion and a second portion arranged in a radial direction of the wire winding member, said second portion having a width less than a width of said first portion such that said locking block forms a stop surface, said wire winding member further including a stop block disposed in said chute, said stop surface abutting said stop block upon entry of said second portion into said chute to limit entry of said first portion into said chute.

6. The wire takeup device of claim 1 wherein said locking block includes a drive ramp and a sliding surface, an included angle between said drive ramp and said sliding surface being greater than 0 degrees and less than 90 degrees; the locking block moves radially relative to the winding piece through the sliding surface; the drive ramp is configured to receive drive to move the locking block radially relative to the wire winding member.

7. The wire takeup device of claim 6 wherein said drive ramp is inclined relative to the central axis of said wire winding member and said drive ramp gradually approaches the central axis of said wire winding member from its proximal end to its distal end.

8. The wire takeup device of any one of claims 1 to 7 wherein said locking block includes a drive portion and a locking portion projecting proximally relative to said drive portion to form a yielding position;

when the wire collecting device is in a locking state, the locking part is abutted with the stop block so as to limit the rotation of the wire winding assembly relative to the shell;

when the wire collecting device is in an unlocking state, the stop block can pass through the avoiding position.

9. The wire takeup device of any one of claims 1 to 7 wherein said resilient member is located around a radially outer side of said locking block to provide a force to said locking block to bring said locking block into abutment with said stop block.

10. The wire takeup device of any one of claims 1 to 7 wherein said elastic member includes a spring plate including a projection and a connecting portion on either side of the projection, said connecting portion being fixedly connected to said wire winding member, said projection projecting radially inwardly of said wire winding member, said projection abutting said locking block and providing a force to said locking block to cause said locking block to abut said stop block.

11. The wire winding device according to any one of claims 1 to 7, wherein the elastic member comprises an elastic loop, and the elastic loop is sleeved on the winding member and abuts against the locking block.

12. The wire takeup device of any one of claims 1 to 7 wherein said housing is provided with a first through hole and said wire winding member is provided with a second through hole, said first and second through holes being configured for passage of said flexible wire, said wire winding assembly being configured for rotation relative to said housing to wind or unwind said flexible wire to or from said wire winding member.

13. A wire winding system comprising a delivery device and the wire winding device of any one of claims 1-12, the delivery device comprising an outer tube, an inner tube movably mounted in the outer tube, and an elongate rod movably mounted in the inner tube, a distal end of the outer tube being connected to the housing and being relatively rotation-stopped, a distal end of the inner tube being connected to the spool and being relatively rotation-stopped;

Wherein the outer tube is configured to limit rotation of the housing, the elongate rod is configured to provide an external force to the locking block to move the locking block radially relative to the wire winding member out of the limit of the stop block, and the inner tube is configured to drive rotation of the wire winding assembly relative to the housing.

14. An implant comprising a flexible wire connecting a plurality of anchors and a wire receiving device according to any one of claims 1-12, each of the anchors being configured to anchor to tissue, a plurality of anchors configured to adjust a spacing of the anchors relative to each other, and the wire receiving device being configured to adjust a length of the flexible wire and lock the length of the flexible wire.