Apparatus and system for changing mitral valve annulus geometry

A system for changing a geometry of a mitral valve annulus of a heart, the system comprising:

• an apparatus comprising:
• an anchor having a body configured to be positioned within and anchored to a coronary sinus vein of the heart, the body having:
• a first end and a second end, the first end spaced apart from the second end;
• a longitudinally extending axis;
• and
• a wall having an interior volume extending from the first end to the second end;
• and
• a first link member having a proximal end nearest to the anchor and a distal end spaced apart from the proximal end, the proximal end of the first link member being movably coupled to the first end of the anchor by a first joint configured to provide for movement of the first link member in one direction relative to the anchor;
• wherein the distal end of the first link member is movably coupled to the anchor by a first actuating tendon and the proximal end of the first link member is coupled to the anchor by a first release tendon, the first actuating tendon being configured to control the movement of the first link member in a first direction towards the mitral valve annulus to apply a first force to a portion of the mitral valve annulus;
• and
• wherein the first joint comprises a ratchet having a first pawl and a first plurality of teeth, the first release tendon being coupled to the first pawl to release the first pawl from the first plurality of teeth;
• and
• a steerable catheter comprising:
• a catheter body;
• and
• a sub-catheter extending from the catheter body, the sub-catheter being adapted to engage the first link member when the sub-catheter is positioned in the interior volume of the anchor of the apparatus.

A method of changing a geometry of a mitral valve annulus of a heart, the method comprising:

• implanting an apparatus into a coronary sinus vein of the heart, the apparatus comprising:
• an anchor having a body, the body having:
• a first end and a second end, the first end spaced apart from the second end;
• a longitudinally extending axis;
• a wall having an interior volume extending from the first end to the second end;
• and
• a first link member having a proximal end nearest to the anchor and a distal end spaced apart from the proximal end, the proximal end of the first link member being movably coupled to the first end of the anchor by a first joint configured to provide for movement of the first link member in one direction relative to the anchor;
• wherein the distal end of the first link member is movably coupled to the anchor by a first actuating tendon and the proximal end of the first link member is coupled to the anchor by a first release tendon, the first actuating tendon being configured to control the movement of the first link member in a first direction towards the mitral valve annulus to apply a first force to a portion of the mitral valve annulus;
• and
• wherein the first joint comprises a ratchet having a first pawl and a first plurality of teeth, the first release tendon being coupled to the first pawl to release the first pawl from the first plurality of teeth;
• and
• adjusting the apparatus with a steerable catheter, the steerable catheter comprising:
• a catheter body;
• and
• a sub-catheter extending from the catheter body, the sub-catheter engaging the apparatus when the sub-catheter is inserted into the interior volume of the anchor to adjust a position of the first link member to apply a force against the mitral valve to change the geometry of the mitral valve annulus.