CN220141884U

CN220141884U - Transcatheter annuloplasty system and locking device

Info

Publication number: CN220141884U
Application number: CN202320746337.1U
Authority: CN
Inventors: 郭荣辉; 张庭超; 计运卓
Original assignee: Hangzhou Valgen Medtech Co Ltd
Current assignee: Hangzhou Valgen Medtech Co Ltd
Priority date: 2023-04-04
Filing date: 2023-04-04
Publication date: 2023-12-08
Anticipated expiration: 2033-04-04

Abstract

The present application provides a transcatheter annuloplasty system and a lock. The transcatheter annuloplasty system comprises a plurality of anchors, a flexible elongate member, an anchor tool, a lock, and a locking tool. The plurality of anchors are configured to sequentially anchor to cardiac tissue. The flexible elongate member is coupled to a plurality of anchors. The flexible elongate member is configured to adjust the spacing between the plurality of anchors. Each anchor is removably attached to a distal end of an anchor tool configured to actuate each anchor to cardiac tissue. The lock is connected to the flexible elongate member. The locking tool is configured to actuate the lock to lock the length of the flexible elongate member to maintain tension in the flexible elongate member. According to the transcatheter valve ring forming system, the flexible slender piece is not required to be sewn on a forming ring, so that the probability of interference between the anchoring piece and the flexible slender piece is reduced, and the operation safety is improved.

Description

Transcatheter annuloplasty system and locking device

Technical Field

The application relates to the field of medical instruments, in particular to a transcatheter annuloplasty system and a locker.

Background

The mitral valve is a one-way valve of the left atrium and left ventricle. The mitral valve opens and blood flows from the left atrium to the left ventricle through the mitral valve orifice; the mitral valve closes, preventing regurgitation of blood from the left ventricle to the left atrium. The tricuspid valve is a one-way valve for the right atrium and right ventricle. The tricuspid valve opens and blood flows from the right atrium to the right ventricle through the tricuspid valve orifice; the tricuspid valve closes, preventing regurgitation of blood from the right ventricle to the right atrium. 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. In recent years, transcatheter invasive annuloplasty has become popular due to its minimal invasive, low risk, rapid recovery, etc. According to the interventional valve forming ring disclosed in the prior art, a plurality of anchors are sequentially implanted through a catheter path to fixedly connect the forming ring with a natural valve ring step by step, and wires on the forming ring are tensioned, so that the size of the valve ring is reduced, and reflux is relieved. However, since the wire is sewn on the forming ring in advance, the anchor is wrapped in the forming ring, and the tip of the anchor passes through the forming ring to fix the forming ring on the natural valve ring, the interference of the anchor and the wire easily occurs in the process, and the position of the wire is difficult to adjust, so that the safety of the operation is seriously affected.

Disclosure of Invention

Embodiments of the present utility model provide a transcatheter annuloplasty system. The transcatheter annuloplasty system comprises a plurality of anchors, a flexible elongate member, an anchor tool, a lock, and a locking tool. The plurality of anchors are configured to sequentially anchor to cardiac tissue. The flexible elongate member connects the plurality of anchors. The flexible elongate member is configured to adjust a spacing between the plurality of anchors. Each of the anchors is detachably connected to a distal end of the anchor tool, the anchor tool being configured to actuate each of the anchors to anchor to the cardiac tissue. The lock is coupled to the flexible elongate member. The locking means is configured to actuate the lock to lock the length of the flexible elongate member to maintain tension in the flexible elongate member.

The transcatheter annuloplasty system of embodiments of the present application implants a plurality of anchors connected by flexible elongate members in heart tissue, and reduces patient annulus size by reducing the spacing between the plurality of anchors to achieve the goal of reducing regurgitation in blood. In this way, the flexible elongate member does not need to be sewn on a forming ring, and the probability of interference between the anchor member and the flexible elongate member is reduced; in addition, the flexible elongate member has high mobility, and even if the anchor piece interferes with the flexible elongate member, the flexible elongate member can be controlled to assist in solving the interference problem, so that the operation safety is improved.

Embodiments of the present application provide a lock. The lock includes at least two clamping members configured to be selectively separable from and closeable to each other. At least two clamping members lock the length of the flexible elongate member when closed.

The locker of the embodiment of the application locks the length of the flexible elongated member by closing at least two clamping pieces, and has simple structure and convenient operation.

Drawings

In order to more clearly describe the embodiments of the present application or the technical solutions in the background art, the drawings used for 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 application and that other drawings may be derived from these drawings without undue effort.

FIG. 1 is a schematic illustration of the structure of a transcatheter annuloplasty system according to an embodiment of the present application;

FIG. 2 is a schematic illustration of a plurality of anchors of one embodiment of the present application after implantation in heart tissue and with the flexible elongate member untwisted;

FIG. 3 is a schematic view of the flexible elongate member of FIG. 2 being tightened;

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

FIG. 5 is a schematic view of the structure of an anchor according to another embodiment of the present application;

FIG. 6 is a schematic view of the anchor shown in FIG. 5 partially within the lumen of a delivery sheath;

FIG. 7 is a schematic view of a delivery sheath delivery anchor according to one embodiment of the present application;

FIG. 8 is a cross-sectional view of FIG. 7;

FIG. 9 is a schematic illustration of the attachment structure to the distal end of the flexible elongate member in accordance with one embodiment of the present application;

FIG. 10 is a schematic illustration of the attachment of another embodiment of the attachment structure to the distal end of a flexible elongate member;

FIG. 11 is a schematic illustration of the attachment structure of FIG. 9 to a flexible elongate member, anchor;

FIG. 12 is another schematic illustration of the attachment structure of FIG. 9 to a flexible elongate member, anchor;

FIG. 13 is a schematic illustration of the attachment of a further embodiment of the attachment structure to the distal end of a flexible elongate member;

FIG. 14 is a schematic illustration of the attachment of a connection structure to an anchor according to yet another embodiment of the present application;

FIG. 15 is a schematic illustration of the attachment of an anchor tool to an anchor according to one embodiment of the present application;

FIG. 16 is a schematic illustration of the anchor tool of FIG. 15 separated from the anchor;

FIG. 17 is a schematic view of the structure of a lock according to an embodiment of the present application;

FIGS. 18 and 19 are partial schematic views of the latch of FIG. 17;

FIG. 20 is a cross-sectional view of the lock of FIG. 17 in connection with a locking tool;

FIG. 21 is a schematic view of a lock in accordance with another embodiment of the present application;

FIG. 22 is an exploded view of the latch of FIG. 21;

FIG. 23 is another exploded view of the latch of FIG. 21;

FIG. 24 is a cross-sectional view of the lock of FIG. 21 coupled to a locking tool (with the two clamping members in a separated state);

FIG. 25 is a schematic view of a portion of the structure of the latch of FIG. 21 (with the two clamping members in a separated state);

FIG. 26 is a cross-sectional view of the latch of FIG. 21 (with the two clamping members in a closed position);

FIG. 27 is a schematic view of a portion of the latch of FIG. 21 (with the two clamping members in a closed position);

FIG. 28 is a schematic view of a lock in accordance with yet another embodiment of the present application;

FIG. 29 is a schematic view of a plurality of anchors of another embodiment of the present application after implantation in heart tissue and the flexible elongate member is contracted;

FIG. 30 is a schematic view of a plurality of anchors of yet another embodiment of the present application after implantation in heart tissue and with the flexible elongate member untwisted;

FIG. 31 is a schematic view of the flexible elongate member of FIG. 30 being tightened;

FIG. 32 is a schematic view of a scenario in which an anchor is implanted in the mitral valve annulus according to an embodiment of the present application;

33-36 are schematic views of a process for sequentially implanting a plurality of anchors in a mitral valve annulus in accordance with one embodiment of the present application;

fig. 37 is a schematic view of an embodiment of the present application utilizing a lock to lock the length of a flexible elongate member.

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 embodiments of the application. All other embodiments, based on the embodiments of the application, which are apparent to those of ordinary skill in the art without inventive faculty, are intended to be within the scope of the application.

The term "proximal" and "distal" are defined herein as terms commonly used in the interventional medical arts. 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 a direction parallel to the central line of the distal and proximal ends of the instrument or component, radial refers to a direction perpendicular to the axial direction, and circumferential refers to a direction around the axial direction. 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 application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application.

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, 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.

References to directional terms in the embodiments of the present application, such as "upper", "lower", "left", "right", "inner", "outer", etc., are only with reference to the directions of the drawings, and thus, the directional terms are used in order to better and more clearly describe and understand the embodiments of the present application, and do not 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 embodiments of the present application, 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.

In the embodiment of the present application, the character "/", generally indicates that the front-rear association object is an or relationship. The specific meaning of the above terms in the present application can be understood by those of ordinary skill in the art according to the specific circumstances.

The disclosure herein provides many different embodiments or examples for implementing different structures of the application. It is to be understood that the specific embodiments described herein are merely illustrative of the related application and not limiting thereof. It should be noted that, for convenience of description, only the portions related to the 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. 1-3, an embodiment of the present application provides a transcatheter annuloplasty system 100. The transcatheter annuloplasty system 100 comprises a plurality of anchors 10, a flexible elongate member 11, an anchor tool 12, a lock 13, and a locking tool 14. The plurality of anchors 10 are configured to sequentially anchor to cardiac tissue. The flexible elongate member 11 connects a plurality of anchors 10. The flexible elongate member 11 is configured to adjust the spacing between the plurality of anchors 10. Each anchor 10 is removably attached to the distal end of an anchor tool 12, the anchor tool 12 being configured to drive each anchor 10 to anchor to cardiac tissue. A lock 13 is attached to the flexible elongate member 11. The locking means 14 is configured to actuate the lock 13 to lock the length of the flexible elongate member 11 to maintain tension in the flexible elongate member 11.

The transcatheter annuloplasty system 100 of embodiments of the present application implants a plurality of anchors 10 connected by flexible elongate members 11 in heart tissue to reduce patient annulus size by reducing the spacing between the plurality of anchors 10 for the purpose of reducing regurgitation in blood. In this way, there is no need to sew the flexible elongate member 11 to a forming ring, reducing the probability of the anchor 10 interfering with the flexible elongate member 11; in addition, the flexible elongate member 11 is highly movable, and even if the anchor 10 interferes with the flexible elongate member 11, the flexible elongate member 11 can be manipulated to assist in solving the interference problem, improving the safety of the operation.

It will be appreciated that the plurality of anchors 10 connected by the flexible elongate member 11 may be anchored to heart tissue such as the mitral valve annulus, tricuspid valve annulus, left ventricular wall or right ventricular wall, and tightening the flexible elongate member 11 may reduce the spacing between the plurality of anchors 10 and thereby the annulus, and the length of the flexible elongate member 11 may be locked by the lock 13 after the annulus has been reduced to the desired effect to maintain the tension of the flexible elongate member 11 and thereby maintain the effect of the annulus reduction. When the anchor 10 and the flexible elongate member 11 are implanted in the annulus, the annulus is contracted directly by tightening the flexible elongate member 11; when the anchor 10 and flexible elongate member 11 are implanted in the wall of the ventricle below the annulus, e.g. 0.5-2cm below the annulus, the reduction of the volume of the ventricle can also be achieved by constricting the flexible elongate member 11 to constrict the ventricle. It should be noted that the volume reduction of the left ventricle can also treat ischemic heart failure.

The flexible elongated member 11 may be a wire, a filament, a rope, a strip, a belt, etc. having a certain axial length and having a flexible radial cross-sectional shape, which may be circular, oblate, rectangular, square, or other shape, etc., which is not limited in the present application. The flexible elongate member 11 can be made of a metallic or polymeric material, preferably a biocompatible material such as stainless steel 316L, tungsten, tantalum, nickel titanium, polyethylene, polyamide, polypropylene, polyurethane, etc. Illustratively, the flexible elongate member 11 is an elongate wire, such as a metal wire.

In some embodiments, transcatheter annuloplasty system 100 further comprises a plurality of connection structures 15. Each of the plurality of connecting structures 15 connects a respective anchor 10 of the plurality of anchors 10 to the flexible elongate member 11. After the connecting structure 15 of the first anchor 10 (hereinafter referred to as the first anchor 10) anchored to the heart tissue is connected to the distal end of the flexible elongate member 11, the distal end of the flexible elongate member 11 may be secured by a fastener or the connecting structure 15 of the flexible elongate member 11 and the first anchor 10 may be prevented from being separated and always kept connected by tying, winding, welding, or bonding. The connecting structure 15 of the remaining anchors 10 (hereinafter remaining anchors 10) anchored to the heart tissue may slide along the flexible elongate member 11 or the flexible elongate member 11 may slide through the connecting structure 15 of the remaining anchors 10.

Referring to fig. 4 and 5, in some embodiments, anchor 10 includes an anchor portion 101 and an anchor mount 102 disposed at a proximal end of anchor portion 101. The anchor 101 has a distal tip 1011 that is easily pierced through tissue. Wherein the anchor 102 is removably attachable to the distal end of the anchor tool 12. The anchor 101 is for engagement with heart tissue. The anchor mount 102 may be made of stainless steel, titanium alloy, cobalt alloy, or polyetheretherketone (Poly ether ether ketone, PEEK).

Referring to fig. 4, in some examples, the anchor 101 may be a screw, which is fixedly coupled to the anchor mount 102, and the anchor 10 is rotated by rotation of the anchor tool 12 to anchor the screw into tissue. The screw may be made of stainless steel, titanium alloy or cobalt alloy. Referring to fig. 5 and 6, in other examples, the anchor 101 may be a plurality of pre-bent nails made of a shape memory material (e.g., nickel-titanium based shape memory alloy, copper based shape memory alloy, iron based shape memory alloy, etc.), and the anchor 10 is anchored into tissue by pushing of the anchor tool 12. When anchor 10 is positioned within lumen 161 of delivery sheath 16, the pre-curved spike is deformed by the constraint of delivery sheath 16, reducing the overall radial dimension; when anchor 10 is disengaged from delivery sheath 16, the pre-curved spike resumes the pre-shaped curved shape. The pre-curved peg limits the curvature of the anchor 10 as it comes off in engagement with heart tissue.

In some embodiments, the flexible elongate member 11 is capable of movement relative to the plurality of anchors 10 after the lock 13 locks the length of the flexible elongate member 11. It will be appreciated that, due to the relative sliding movement between the flexible elongate member 11 and the attachment structure 15 of the anchor 10, the flexible elongate member 11 may move with respect to the anchor 10 with a slight displacement under the cyclical movement of the mitral valve, tricuspid valve.

Referring to fig. 7 and 8, in some embodiments, transcatheter annuloplasty system 100 further comprises delivery sheath 16. Delivery sheath 16 has a lumen 161 and a distal nozzle 162 that communicates with lumen 161. The anchor tool 12 and the anchor 10 are movably disposed through the lumen 161 of the delivery sheath 16, the anchor tool 12 being configured to drive the anchor 10 away from the distal orifice 162 to anchor to cardiac tissue. It will be appreciated that delivery of anchor 10 to heart tissue via delivery sheath 16, distal nozzle 162 of delivery sheath 16 abuts a target site in heart tissue, facilitating anchoring of anchor 10 at the target site driven by anchor tool 12.

Referring again to fig. 1, in some embodiments, the transcatheter annuloplasty system 100 further comprises a guiding device 17. The introducer 17 includes a first introducer sheath 171 and a second introducer sheath 172 movably mounted within the first introducer sheath 171. The second guide sheath 172 can be extended from the distal end of the first guide sheath 171 and adjusted to the vicinity of the heart tissue, thereby establishing an interventional channel 1510 from the outside of the body to the heart, i.e., establishing a delivery channel from the outside of the body to the heart tissue. Delivery sheath 16 is flexible at least at a distal portion thereof, and delivery sheath 16 may be advanced along a delivery path into the heart.

Preferably, the first and second guide sheaths 171, 172 are both adjustable bend sheaths, facilitating adjustment of the degree and direction of bending of the distal end portion thereof, so that the second guide sheath 172 is easily adjustable to the vicinity of the heart tissue. In other embodiments, the introducer 17 may employ only one adjustable bend sheath as the introducer sheath. The guiding sheath tube with adjustable bending is a guiding device 17 commonly used in interventional operations in the prior art, and is not described herein.

Referring to fig. 9-12, in some embodiments, the connecting structure 15 includes a flexible sheet 151. The flexible sheet 151 is configured to be connected to the anchor 10. The flexible sheet 151 has a channel 1510 with the flexible elongate member 11 threaded through the channel 1510 to connect the respective anchors 10 to the flexible elongate member 11. It will be appreciated that the distal tip 1011 of the anchor portion 101 is capable of piercing the flexible sheet 151, the flexible sheet 151 being attached to the proximal end of the anchor portion 101 by rotating the anchor 10 or pushing the anchor 10 to move relative to the flexible sheet 151. Note that flexible sheet 151 cannot pass through anchor 102. Thus, the flexible elongate member 11 is connected to the anchor 10 by the flexible sheet 151.

In the illustrated example, the flexible elongate member 11 can be a wire having a free end that passes through the channel 1510 of the flexible sheet 151 and then is looped around to form a closed loop by welding, connecting the flexible sheet 151 of the first anchor 10 to the distal end of the flexible elongate member 11. The wire is threaded through the channel 1510 of the flexible sheet 151 of the remaining anchor 10 and can slide relative thereto. Of course, the flexible elongate member 11 may also be a polymer wire. The distal end of the flexible elongate member 11 and the flexible sheet 151 of the first anchor 10 may be connected in any of the manners described above for connecting the connecting structure 15 of the first anchor 10 to the distal end of the flexible elongate member 11, as the application is not limited in this regard.

Referring to fig. 10, the channels 1510 of the flexible sheet 151 include a first channel 1510a and a second channel 1510b. The flexible elongate member 11 comprises a first portion 111 and a second portion 112. First portion 111 is threaded through first channel 1510a. The second portion 112 is threaded through the second channel 1510b. The respective anchor 10 is located between the first portion 111 and the second portion 112. Thus, the flexible elongate member 11 is of a two-wire construction. The first portion 111 and the second portion 112 are threaded in the first channel 1510a and the second channel 1510b, respectively, so that the first portion 111 and the second portion 112 can be prevented from interfering with each other and winding, and smooth sliding of the flexible elongated member 11 in the channel 1510 can be ensured. Referring to fig. 11 and 12, the flexible sheet 151 may be provided with only one channel 1510, and the first portion 111 and the second portion 112 of the flexible elongate member 11 may be threaded through the same channel 1510. In addition, the flexible elongate member 11 may be of a single wire construction, in which case the flexible sheet 151 need only be provided with one channel 1510.

The flexible sheet 151 is a sheet-like structure and may be circular, oval, rectangular, square, or other polygonal shape. The flexible sheet 151 may be made of a polymer material such as polyethylene terephthalate (Polyethylene terephthalate, PET), polyethylene, polypropylene, or the like. The flexible sheet 151 includes at least two connection tabs 1511, and the distal tip of the anchor 10 is capable of piercing the connection tabs 1511 to connect the flexible sheet 151 with the anchor 10.

Referring again to fig. 7 and 8, in delivering anchor 10, flexible sheet 151 is positioned at distal nozzle 162 of delivery sheath 16, and distal tip 1011 of anchor 10 is configured to pierce flexible sheet 151 to connect flexible sheet 151 with anchor 10. It will be appreciated that because anchor tool 12 and anchor 10 are movably disposed through lumen 161 of delivery sheath 16, flexible elongate member 11 is threaded through flexible sheet 151 disposed at distal nozzle 162 of delivery sheath 16, flexible elongate member 11 may be positioned outside of delivery sheath 16, i.e., anchor 10 is spaced from flexible elongate member 11 by the wall of delivery sheath 16. In this way, the flexible elongate member 11 is prevented from becoming entangled with the anchoring portion 101 of the anchor 10, avoiding affecting implantation of the anchor 10.

When the anchor 10 is conveyed, the distal tip 1011 of the anchor 10 pierces the flexible sheet 151, or may pierce only a part of the connecting piece 1511 of the flexible sheet 151, or may pierce all of the connecting pieces 1511 of the flexible sheet 151, so as to ensure that the flexible sheet 151 is stably connected to the anchor 10, and the flexible sheet 151 does not fall off.

In some embodiments, the anchor 101 is a screw, and the area of the flexible sheet 151 is greater than 2 times the cross-sectional area of the screw and less than 5 times the cross-sectional area of the anchor 102. It will be appreciated that after the distal tips 1011 of the screw pierce the flexible sheet 151, the flexible sheet 151 can be moved to the proximal end of the screw by rotating the screw to drive movement of the screw relative to the flexible sheet 151. Therefore, the area of the flexible sheet 151 is greater than 2 times the cross-sectional area of the screw, so that the screw can be ensured not to be separated from the flexible sheet 151 during rotation, and the anchor 10 can be stably installed on the anchor 10 by the flexible sheet 151 after anchoring into heart tissue. The area of the flexible sheet 151 is less than 5 times the cross-sectional area of the anchor 102, preventing the flexible sheet 151 from being oversized relative to the anchor 10 while avoiding unnecessary added cost.

Preferably, flexible sheet 151 has an area sufficient to completely cover distal nozzle 162 of delivery sheath 16. In this way, delivery sheath 16 presses against flexible sheet 151 during implantation of anchor 10, preventing rotation of anchor 10 to rotate flexible sheet 151. In addition, rotation of the flexible sheet 151 following the anchor 10 can also be avoided by tensioning the flexible elongate member 11.

In addition, the flexible sheet 151 may have a thickness in the range of 0.03mm to 2mm, which is less than 1/3 of the length of the anchor portion 101, to ensure that the anchor portion 101 is mostly anchored in tissue after the anchor 10 is implanted in tissue.

Referring to fig. 13, in other embodiments, the connecting structure 15 includes a cover 1521 that covers the anchor 10 and an attachment element 1522 that connects the cover 1521. The attachment element 1522 and the covering film 1521 define a connection aperture 1523 therebetween, the flexible elongate member 11 being threaded through the connection aperture 1523 to connect the respective anchor 10 to the flexible elongate member 11. In this way, the flexible elongate member 11 is connected to the anchor 10 through the connection hole 1523 defined between the attachment element 1522 and the covering film 1521. The covering film 1521 may be sewn to the anchor mount 102 of the anchor 10 by stitching. The attachment element 1522 and the cover film 1521 are connected by suture. The covering film 1521 may be rotated relative to the anchor block 102 to prevent the flexible elongate member 11 from wrapping around the anchor 10 as the anchor 10 rotates. The wrapping film 1521 and the attachment member 1522 may be made of a polymer material such as PET, polyethylene, or polypropylene, and the materials may be identical or different. The suture can also be made of polymer materials such as PET, polyethylene or polypropylene.

Referring to fig. 14, in still other embodiments, the connecting structure 15 includes a cover 153 that covers the anchor 10. The coating film 153 has a connection port 1530. The flexible elongate member 11 is threaded through the connection port 1530 to connect the respective anchor 10 to the flexible elongate member 11. Thus, the flexible elongate member 11 is connected to the anchor 10 through the connection port 1530 of the cover 153. The cover 153 may be sewn to the anchor mount 102 of the anchor 10 by stitching. A stitch can be sewn at the connection port 1530 of the coating film 153 to ensure the strength and toughness of the connection port 1530 and avoid the enlargement of the connection port 1530. The cover 153 may rotate relative to the anchor mount 102 to prevent the flexible elongate member 11 from wrapping around the anchor 10 as the anchor 10 rotates. The wrapping film 153 and the suture can be made of polymer materials such as PET, polyethylene or polypropylene, and the materials used by the wrapping film 153 and the suture can be consistent or inconsistent.

In other embodiments, the connection structure 15 may be a connection hole formed in the anchor mount 102. The flexible elongate member 11 is threaded through the attachment aperture to attach the respective anchor 10 to the flexible elongate member 11.

Referring to fig. 15 and 16, in some embodiments, the anchor tool 12 includes a first drive tube 121 and a first connecting rod 122 threaded into the first drive tube 121. The proximal end of the anchor 102 and the distal end of the first drive tube 121 are provided with cooperatively connected S-shaped snaps, respectively. The S-shaped buckle of the anchor seat 102 and the S-shaped buckle of the first driving tube 121 are buckled to form an inner cavity, and the first connecting rod 122 penetrating into the first driving tube 121 is inserted into the inner cavity to enable the anchor 10 to be connected with the first driving tube 121. The screw may be anchored into the tissue by rotating the first drive tube 121 to drive the anchor 10 in rotation, or the anchor tool 12 may be pushed entirely to drive the pre-bent screw of the anchor 10 into the tissue. It will be appreciated that the anchor 10 can be separated from the first drive tube 121 by withdrawing the first connecting rod 122 from the two S-shaped snap-fit snap-in engagement.

Referring to fig. 17-20, in some embodiments, the lock 13 includes a housing 1311, a limit post 1312, a resilient member 1313, a stop runner 1314, and a spool 1315. Wherein housing 1311 is provided with proximal opening 1311a. The limit posts 1312 are fixedly coupled to an inner bottom portion of the housing 1311. The stopping wheel 1314 is axially movably sleeved on the limiting column 1312 and is stopped relative to the housing 1311. Spool 1315 rotatably fits over post 1312 and is in unidirectional rotational engagement with stop wheel 1314. The proximal end portion of the spool 1315 is provided with a screw hole 1315a in its axial direction, and the proximal end portion thereof protrudes from a proximal end opening 1311a of the housing 1311. The elastic element 1313 abuts between the housing 1311 and the stopper 1314 to provide elastic force to the stopper 1314. The spool 1315 is provided with a through hole 1315b in a radial direction thereof, and the housing 1311 is also provided with through holes 1311b at both sides of the spool 1315.

The lock 13 is detachably connected to the distal end of the locking tool 14. The locking tool 14 includes a threaded rod 1411, a swivel 1412, and an outer sheath 1413 that are provided from inside to outside. Wherein the outer sheath 1413 is snapped into engagement with the housing 1311 to limit rotation of the housing 1311. The rotation tube 1412 is sleeved on a proximal end portion of the spool 1315 and the rotation tube 1412 is stopped relative to the spool 1315. The threaded rod 1411 is threadedly coupled to the threaded bore 1315a of the spool 1315 to maintain the connection of the rotary tube 1412 to the spool 1315 by cooperating stop bosses.

It will be appreciated that after the plurality of anchors 10 connected by the flexible elongate member 11 are anchored to the heart tissue, threading the flexible elongate member 11 around the housing 1311 and spool 1315 of the lock 13, and then rotating the rotation tube 1412 to rotate the spool 1315 in a single direction relative to the housing 1311 winds the flexible elongate member 11 to tighten the flexible elongate member 11 to reduce the spacing between the plurality of anchors 10 to reduce the size of the patient's annulus. After the desired effect of the reduction of the annulus is achieved, the rotation of the rotation tube 1412, i.e., the spool 1315, is stopped, and the flexible elongate member 11 is locked between the spool 1315 and the housing 1311, i.e., the drive lock 13 locks the length of the flexible elongate member 11 to maintain the tension of the flexible elongate member 11, thereby maintaining the effect of the reduction of the annulus. Because of the frictional forces between the winding of the flexible elongate member 11 around the spool 1315 and the spool 1315, the tension on the flexible elongate member 11 caused by leaflet or heart action is resisted, ensuring that the flexible elongate member 11 is not pulled.

Referring to fig. 21-27, in other embodiments, the lock 13 includes at least two clamping members 1321, the at least two clamping members 1321 being configured to be selectively separable from and closeable to one another. The length of the flexible elongate member 11 is locked when the at least two clamping members 1321 are closed. In this way, the flexible elongate member 11 can be threaded therein when the at least two clamping members 1321 are separated, and the flexible elongate member 11 can be clamped by operating the at least two clamping members 1321 to close, thereby locking the length of the flexible elongate member 11 to maintain tension of the flexible elongate member 11. The locking device 13 is closed by at least two clamping members 1321 to lock the length of the flexible elongated member 11, and has a simple structure and convenient operation.

In the illustrated example, the number of clamping members 1321 is two. Each clamping member 1321 is provided with a protrusion 1321a and/or a recess 1321b, the protrusion 1321a of each clamping member 1321 mating with the recess 1321b of the other clamping member 1321. The clamping effect on the flexible elongated member 11 is enhanced by the cooperation of the protrusions 1321a and the grooves 1321b between the two clamping members 1321. Of course, the number of the clamping members 1321 may be three, four, or even five, etc., which is not limited by the present application.

Specifically, the lock 13 further includes a housing 1322, a push shaft 1323, and an elastic member 1324. The housing 1322 defines an interior space 1322a through which the flexible elongate member 11 passes. The interior space 1322a has a distal chamfer 1322b. At least two clamping members 1321 are movably received in the interior space 1322a. Each clamp 1321 defines a slide guide surface 1321c. The elastic member 1324 abuts between the housing 1322 and at least two clamping members 1321. The elastic member 1324 is configured to hold at least two clamping members 1321 in a separated state. The pushing shaft 1323 is configured to push the at least two clamping members 1321 to move the sliding guide surface 1321c over the distal ramp 1322b to close the at least two clamping members 1321 and to maintain the at least two clamping members 1321 in a closed state.

It will be appreciated that the clamping member 1321 cooperates with the interior space 1322a of the housing 1322 in a planar manner such that the clamping member 1321 is movable in the axial direction of the housing 1322, while the clamping member 1321 is not rotatable relative to the housing 1322. The housing 1322 has a through hole 1322c communicating with the internal space 1322a, and the pushing shaft 1323 passes through the through hole 1322c to contact with the clamping member 1321, so that the clamping member 1321 can be pushed to move in the housing 1322. The elastic member 1324 provides elastic force to the at least two clamping members 1321 so that the at least two clamping members 1321 can be in a separated state.

The housing 1322 may include an upper housing and a lower housing, which may be fixed by welding or screwing or clamping. In this way, the clamping member 1321, the elastic member 1324, etc. are conveniently fitted to the inner space 1322a of the housing 1322. The peripheral wall of the housing 1322 is provided with two through holes 1322d communicating with the internal space 1322a thereof, or the axially opposite end walls of the housing 1322 are respectively provided with through holes 1322d communicating with the inside thereof. The central axes of the two through holes 1322d may be on the same straight line or parallel. The central axes of the two through holes 1322d may also intersect, and the included angle between the central axes of the two through holes 1322d is preferably greater than 150 ° and less than 210 °. After the plurality of anchors 10 connected by the flexible elongate member 11 are anchored to the cardiac tissue, the flexible elongate member 11 is passed through the two through holes 1322d of the housing 1322 such that the flexible elongate member 11 is positioned between the at least two clamping members 1321 in a separated state, and the flexible elongate member 11 is movable between the at least two clamping members 1321.

The flexible elongate member 11 can be tightened by pulling, thereby reducing the spacing between the plurality of anchors 10 to reduce the size of the patient's annulus. After the annulus is contracted to its desired effect, at least two clamping members 1321 are pushed by the drive shaft to move their sliding guide surfaces 1321c over the distal ramps 1322b inside the housing 1322 until at least two clamping members 1321 close to clamp the flexible elongate member 11, thereby locking the length of the flexible elongate member 11. The elastic member 1324 is continuously compressed in the process that the pushing shaft 1323 pushes the at least two clamping members 1321 to move to switch from the separated state to the closed state. The pushing shaft 1323 is capable of holding the at least two clamping members 1321 in a closed state after the at least two clamping members 1321 clamp the flexible elongated member 11.

The lock 13 is detachably connected to the distal end of the locking tool 14. The locking tool 14 includes a second drive tube 1421 and a second connecting rod 1422 threaded into the second drive tube 1421. The proximal end of the pushing shaft 1323 and the distal end of the second driving tube 1421 are provided with S-shaped snaps that are cooperatively connected, respectively. The S-shaped buckle of the pushing shaft 1323 and the S-shaped buckle of the second driving tube 1421 are buckled to form an inner cavity, and the second connecting rod 1422 penetrating into the second driving tube 1421 is inserted into the inner cavity, so that the pushing shaft 1323 and the second driving tube 1421 can be kept connected. The pushing shaft 1323 may be driven to push the at least two clamping members 1321 to move by operating the second driving tube 1421. It will be appreciated that the second connecting rod 1422 is withdrawn from the two S-shaped snap-in place, and the push shaft 1323 is separated from the second drive tube 1421.

In one example, the through hole 1322c is provided with an internal thread, the pushing shaft 1323 is provided with an external thread, and the pushing shaft 1323 and the through hole 1322c are connected with the internal thread through the external thread to maintain the at least two clamping members 1321 in a closed state. In another example, one of the housing 1322 and the push shaft 1323 is provided with a resilient catch and the other is provided with a catch. The pushing shaft 1323 passes through the through hole 1322c to make the elastic buckle be snapped into the card slot to keep at least two clamping pieces 1321 in a closed state.

It will be appreciated that the threaded connection, the snap fit, and the snap fit may all define the relative position of the push shaft 1323 and the housing 1322. Thus, when the pushing shaft 1323 pushes the at least two clamping members 1321 to clamp the flexible elongated member 11, the relative position of the pushing shaft 1323 and the housing 1322 is locked, and the pushing shaft 1323 can resist the elastic force of the elastic member 1324 due to compression, so as to keep the at least two clamping members 1321 in the closed state. Because the flexible elongated member 11 is threaded on the housing 1322, the flexible elongated member 11 is pulled and tightened, so that the housing 1322 is kept still, at this time, the rotating driving tube may drive the pushing shaft 1323 to rotate relative to the through hole 1322c to push the at least two clamping members 1321 to move distally, or the pushing driving tube and the second connecting rod 1422 may drive the pushing shaft 1323 to push the at least two clamping members 1321 to move distally. In addition, the locking tool 14 may further include an outer sheath that is sleeved outside the drive tube, and the outer sheath may be engaged with the housing 1322 to enhance the effect of restricting the movement of the housing 1322.

Further, the interior space 1322a also has a stepped surface 1322e that connects to the distal ramp 1322 b. Each clamping member 1321 includes an abutment 1321d and a slide guide 1321e that are connected. Guide surface 1321c is provided on guide portion 1321e. An abutment surface 1321f is formed between the abutment portion 1321d and the slide guide portion 1321e. The elastic member 1324 is sleeved on the sliding guide portion 1321e and abuts against the abutment surface 1321f and the step surface 1322e, respectively. In this way, the elastic member 1324 can hold at least two clamping members 1321 in a separated state. In the illustrated example, the elastic member 1324 is a spring.

Referring to fig. 28 and 29, in yet another embodiment, the lock 13 is a tube member having a lumen through which the flexible elongate member 11 can pass. After the plurality of anchors 10 connected by the flexible elongate member 11 are anchored to the heart tissue, the flexible elongate member 11 is passed through the lumen of the tubular member and the flexible elongate member 11 is then pulled to reduce the spacing between the plurality of anchors 10, thereby reducing the size of the patient's annulus. After the annulus is contracted to the desired effect, the length of the flexible elongate member 11 is locked by applying pressure to the tubular member via the locking means 14 to deform it by compression to grip the flexible elongate member 11. The inner diameter of the tubular member may be greater than 2 times the radial dimension of the flexible elongate member 11. The wall thickness of the pipe body part can be 0.05mm-0.3mm, so that the extrusion deformation is facilitated. One end of the pipe body piece is provided with a boss which can be cylindrical or polygonal. The boss is configured to bear against the last anchor 10 to reduce impact damage to the tubular member with the anchor 10. The pipe body piece can be made of titanium, 316L stainless steel, cobalt and other materials.

Referring to fig. 30 and 31, in some embodiments, the transcatheter annuloplasty system 100 further comprises at least one spacer 18. The spacer 18 is slidably connected to the flexible elongate member 11. Spacers 18 are provided between at least some of the adjacent anchors 10. It will be appreciated that the spacer 18 prevents the flexible elongate member 11 from being too tightly packed to cause damage to heart tissue due to too short a distance between adjacent anchors 10, while the spacer 18 serves to cushion the heart tissue and to distribute the tightening force applied to the anchors 10 to ensure stable implantation of the anchors 10. Wherein the spacer 18 is a cylindrical member having a length, preferably made of a biocompatible material. The spacer 18 may be covered with a coating to reduce the risk of damage to heart tissue by the spacer 18.

Alternatively, a spacer 18 may be provided between any adjacent two anchors 10 of the plurality of anchors 10, i.e., anchors 10 are staggered with respect to spacer 18. Of course, it is also possible to provide a spacer 18 for each of two or more anchors 10, that is, a spacer 18 is provided between two anchors 10 that are partially adjacent, and no spacer 18 is provided between two anchors 10 that are partially adjacent, which is not limited in the present application.

Referring again to fig. 1 and 7, in some embodiments, the transcatheter annuloplasty system 100 further comprises a delivery member 19. The distal end of the delivery member 19 is connected to the proximal end of the flexible elongate member 11. It will be appreciated that the distal end of the flexible elongate member 11 is connected to the first anchor 10. The flexible elongate member 11, delivery member 19, is delivered into the patient with the first anchor 10, and the proximal end of delivery member 19 extends outside the body. In this way, the connecting structure 15, the spacer 18, the locking device 13, etc. of the anchor 10 can be installed on the flexible elongate member 11 through the delivery of the delivery member 19, so that the flexible elongate member 11 can be selected to have a proper implantation length, and thus the flexible elongate member 11 does not need to be cut in vivo, the falling of particles on wires is avoided, and the operation is safer.

The conveying member 19 may be a wire, a filament, a rope, a strip, a belt, or the like having a certain axial length and having flexibility, and the radial cross-sectional shape thereof may be a circular shape, an oblate shape, a rectangular shape, a square shape, or other shapes, and the present application is not limited thereto. The delivery member 19 may be made of a metallic material and/or a polymeric material, preferably a biocompatible material such as stainless steel 316L, tungsten, tantalum, nitinol, polyethylene, polyamide, polypropylene, polyurethane, etc. Illustratively, the delivery member 19 is an elongate wire, such as a polymer wire.

In some embodiments, the proximal end of the flexible elongate member 11 is connected to the distal end of the delivery member 19 in a U-shape, and pulling the delivery member 19 outside of the body allows the delivery member 19 to be separated from the flexible elongate member 11, allowing for easy operation. In other embodiments, the conveying member 19 may be detachably connected to the flexible elongated member 11 by a threaded connection, a snap connection, or the like, which will not be described in detail.

Referring again to fig. 29, delivery member 19 can be omitted from transcatheter annuloplasty system 100 and flexible elongate member 11 can be of a length sufficient to allow the proximal end of flexible elongate member 11 to extend outside the patient's body after flexible elongate member 11 has been advanced into the heart with first anchor 10. Thus, after implantation of the plurality of anchors 10, the flexible elongate member 11 is contracted to contract the annulus, and after the contracted annulus has achieved the desired effect, the length of the flexible elongate member 11 can be locked by any of the above-described locks 13 to maintain the tension of the flexible elongate member 11, thereby maintaining the effect of contracted the annulus. The excess portion of the flexible elongate member 11 may be cut by a wire cutter.

The use and principles of operation of the transcatheter annuloplasty system 100 according to embodiments of the present application will be described below with reference to fig. 1-3 and 32-37, taking as an example the application of the transcatheter annuloplasty system 100 to mitral valve annuloplasty. Wherein, the operation route is: transfemoral vein-inferior vena cava-Right Atrium (RA) -interatrial septum (AS) -Left Atrium (LA) -Mitral Valve Annulus (MVA). The connecting structure 15 employs a flexible sheet 151, the flexible sheet 151 of the first anchor 10 being connected to the distal end of the flexible elongate member 11, the proximal end of the flexible elongate member 11 being connected to the distal end of the delivery member 19 in a U-shape. Anchor tool 12 is threaded into lumen 161 of delivery sheath 16, first anchor 10 may be preassembled with anchor tool 12, flexible sheet 151 placed at distal orifice 162 of delivery sheath 16 and distal tip 1011 of first anchor 10 pierced flexible sheet 151.

The first step: a delivery channel between the outer body and the mitral valve annulus is constructed using a first introducer sheath 171 and a second introducer sheath 172.

And a second step of: first, delivery sheath 16 is advanced distally in the delivery channel to its distal end against the annulus; then, operating the anchor tool 12 to drive the first anchor 10 to anchor into the annulus of the mitral valve; next, delivery sheath 16 is withdrawn proximally to completely disengage first anchor 10 from delivery sheath 16, releasing anchor tool 12 from first anchor 10; finally, the anchor tool 12 and delivery sheath 16 are withdrawn. The flexible sheet 151 is anchored to the annulus with the first anchor 10.

And a third step of: first, the distal end of anchor tool 12 is pushed out of distal nozzle 162 of delivery sheath 16 to attach second anchor 10; thereafter, anchor tool 12 is retracted to allow anchor 10 to enter lumen 161 of delivery sheath 16; next, the flexible sheet 151 of the second anchor 10 is passed through the delivery member 19 and positioned at the distal nozzle 162 of the delivery sheath 16 such that the distal tip 1011 of the second anchor 10 pierces the flexible sheet 151; finally, the position of the second anchor 10 is adjusted according to the size of the annulus, and the second anchor 10 is anchored in the annulus. As delivery sheath 16 is advanced in the delivery channel, flexible sheet 151 is delivered along delivery member 19 onto flexible elongate member 11.

Fourth step: the third step is repeated, sequentially from the anterior leaflet of the mitral valve, along the posterior annulus to the posterior leaflet or vice versa, implanting a sufficient number of anchors 10 in the mitral valve annulus. After implantation of all anchors 10 is completed, anchor tool 12 and delivery sheath 16 are withdrawn.

Fifth step: first, the proximal end of the delivery member 19 is passed through the lock 13, and the lock 13 is fed along the delivery member 19 onto the flexible elongate member 11; then, the length of the flexible elongated member 11 on the valve annulus is adjusted by controlling the rotation of the spool of the locker 13 through the locking tool 14 to reduce the interval between the plurality of anchors 10, thereby driving the valve annulus to contract; then, after a good ring shrinking effect is achieved, the rotation of the winding shaft is stopped, and the length of the flexible elongated member 11 can be locked by the locking device 13 so as to maintain the tension of the flexible elongated member 11; finally, the connection of the locking means 14 to the lock 13 is released, and the lock 13 is withdrawn. It should be noted that the delivery member 19 can be withdrawn after the flexible elongate member 11 is stably connected to the lock 13.

In addition, in the case where a spacer is required between at least some of the anchors, the spacer is advanced into the patient by pushing through the delivery sheath, as follows: first, the spacer 18 is passed through the conveyor 19 and introduced into the conveyor channel; the proximal end of delivery member 19 is then passed through flexible sheet 151 of one of anchors 10 (anchor 10 has been connected to the distal end of anchor tool 12 and distal tip 1011 of anchor 10 pierces flexible sheet 151 disposed at distal orifice 162 of delivery sheath 16); next, delivery sheath 16 is advanced in the delivery channel, with spacer 18 and anchors 10 being delivered onto flexible elongate member 11 along delivery member 19, with spacer 18 interposed between two anchors 10, by forward advancement of delivery sheath 16; finally, the position of the anchor 10 is adjusted according to the size of the annulus, and the anchor 10 is anchored in the annulus. Wherein the distance between the two anchors 10 is greater than the axial length of the spacer 18.

It should be noted that, without conflict, the embodiments of the present application and features of the embodiments may be combined with each other, and any combination of features of different embodiments is also within the scope of the present application, that is, the above-described embodiments may be further combined 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 relationships among the components in the drawings are not intended to limit the actual products of the application.

The above embodiments and implementations of the present application are only some of the embodiments and implementations, the scope of the present application is not limited thereto, and any person skilled in the art can easily think about changes or substitutions within the technical scope of the present application, and the changes and substitutions are intended to be covered by the scope of the present application. Therefore, the protection scope of the application is subject to the protection scope of the claims.

Claims

1. A transcatheter annuloplasty system, comprising:

a plurality of anchors configured to sequentially anchor to cardiac tissue;

a flexible elongate member connecting the plurality of anchors, the flexible elongate member configured to adjust spacing between the plurality of anchors;

An anchor tool, each of the anchors being removably attached to a distal end of the anchor tool, the anchor tool being configured to drive each of the anchors to anchor to the cardiac tissue;

a lock for coupling the flexible elongate member; and

a locking tool configured to actuate the lock to lock the length of the flexible elongate member to maintain tension of the flexible elongate member.

2. The transcatheter annuloplasty system of claim 1, wherein the flexible elongate member is movable relative to the plurality of anchors after the lock locks the length of the flexible elongate member.

3. The transcatheter annuloplasty system of claim 1, further comprising a delivery sheath having a lumen and a distal orifice in communication with the lumen, the anchor tool and the anchor being movably disposed through the lumen of the delivery sheath, the anchor tool being configured to drive the anchor away from the distal orifice and anchored to the heart tissue.

4. The transcatheter annuloplasty system of claim 3, further comprising a plurality of connection structures, each of the plurality of connection structures connecting a respective anchor of the plurality of anchors to the flexible elongate member, the connection structures comprising a flexible sheet configured to connect to the anchor, the flexible sheet having a channel through which the flexible elongate member is threaded to connect the respective anchor to the flexible elongate member.

5. The transcatheter annuloplasty system of claim 4, wherein the anchor comprises an anchor portion and an anchor pad disposed proximal of the anchor portion, the anchor portion having a distal tip;

upon delivery of the anchor, the flexible sheet is disposed at a distal orifice of the delivery sheath, and the distal tip is configured to pierce the flexible sheet to connect the flexible sheet with the anchor.

6. The transcatheter annuloplasty system of claim 5, wherein the anchor is separated from the flexible elongate member by a wall of the delivery sheath.

7. The transcatheter annuloplasty system of any of claims 4-6, wherein the channel comprises a first channel and a second channel, the flexible elongate member comprising a first portion threaded to the first channel and a second portion threaded to the second channel, the respective anchors being located between the first and second portions.

8. The transcatheter annuloplasty system of claim 5 or 6, wherein the anchor is a screw, the flexible sheet having an area greater than 2 times a cross-sectional area of the screw and less than 5 times a cross-sectional area of the anchor.

9. The transcatheter annuloplasty system of claim 3, further comprising a plurality of connection structures, each of the connection structures connecting a respective anchor of the plurality of anchors to the flexible elongate member, the connection structures comprising a covering film over the anchor and an attachment element connecting the covering film, the attachment element and the covering film defining a connection aperture therebetween, the flexible elongate member threaded through the connection aperture to connect the respective anchor to the flexible elongate member.

10. The transcatheter annuloplasty system of claim 3, further comprising a plurality of connection structures, each of the connection structures connecting a respective anchor of the plurality of anchors to the flexible elongate member, the connection structures comprising a cover over the anchor, the cover having a connection port to which the flexible elongate member is threaded to connect the respective anchor to the flexible elongate member.

11. The transcatheter annuloplasty system of claim 1, wherein the lock comprises at least two clamps, at least two of the clamps configured to be selectively separable from and closeable to each other;

At least two of the clamping members lock the length of the flexible elongate member when closed.

12. The transcatheter annuloplasty system of claim 11, wherein the lock further comprises a housing defining an interior space through which the flexible elongate member passes, the interior space having a distal ramp, at least two of the gripping members being movably received in the interior space, each gripping member defining a sliding guide surface, a pushing shaft, and a resilient member, the resilient member being configured to hold the at least two gripping members in a separated state, the pushing shaft being configured to push the at least two gripping members to move the sliding guide surfaces over the distal ramp to close the at least two gripping members and to hold the at least two gripping members in a closed state.

13. The transcatheter annuloplasty system of claim 12, wherein the housing is provided with a through hole communicating with the interior space, wherein the through hole is provided with internal threads, wherein the pushing shaft is provided with external threads, and wherein the pushing shaft and the through hole are connected to the internal threads by the external threads to hold at least two of the gripping members in a closed state; or alternatively

One of the shell and the pushing shaft is provided with an elastic buckle, the other one of the shell and the pushing shaft is provided with a clamping groove, and the pushing shaft penetrates through the through hole to enable the elastic buckle to be clamped into the clamping groove so as to keep at least two clamping pieces in a closed state.

14. The transcatheter annuloplasty system of claim 12, wherein the interior space further has a stepped surface connecting the distal inclined planes, each of the gripping members includes an abutment portion and a guide slide portion connected, the guide slide surface being provided to the guide slide portion, an abutment surface being formed between the abutment portion and the guide slide portion, the resilient member being sleeved to the guide slide portion and abutting the abutment surface and the stepped surface, respectively.

15. The transcatheter annuloplasty system according to any of claims 11 to 14, wherein the number of gripping members is two, each gripping member being provided with a protrusion and/or a groove, the protrusion of each gripping member mating with the groove of the other gripping member.

16. The transcatheter annuloplasty system of claim 1, further comprising at least one spacer slidingly connecting the flexible elongate member, the spacer being disposed between at least a portion of adjacent two of the anchors.

17. The transcatheter annuloplasty system of claim 1, further comprising a delivery member having a distal end coupled to a proximal end of the flexible elongate member.

18. A lock comprising at least two clamping members, at least two of the clamping members configured to be selectively separable from and closeable to one another;

19. The lock of claim 18, further comprising a housing defining an interior space through which the flexible elongate member passes, the interior space having a distal ramp, at least two of the clamping members being movably received in the interior space, each clamping member defining a slide guide surface, a pushing shaft and a resilient member, the resilient member being configured to maintain the at least two clamping members in a separated state, the pushing shaft being configured to push the at least two clamping members to move the slide guide surfaces over the distal ramp to close the at least two clamping members and to maintain the at least two clamping members in a closed state.

20. The lock according to claim 19, wherein the housing is provided with a through hole communicating with the inner space, wherein the through hole is provided with an internal thread, the pushing shaft is provided with an external thread, and the pushing shaft and the through hole are connected with the internal thread through the external thread to keep at least two of the clamping members in a closed state; or alternatively

21. The lock of claim 19, wherein the interior space further has a stepped surface connecting the distal inclined surfaces, each of the clamping members includes an abutment portion and a slide guiding portion connected, the slide guiding surface is provided on the slide guiding portion, an abutment surface is formed between the abutment portion and the slide guiding portion, and the elastic member is sleeved on the slide guiding portion and abuts against the abutment surface and the stepped surface, respectively.

22. A lock according to any one of claims 18 to 21, wherein the number of clamping members is two, each clamping member being provided with a projection and/or recess, the projection of each clamping member co-operating with the recess of the other clamping member.