Implantation of repair devices in the heart

An annuloplasty system comprising:

• a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart of a patient;
• a first tube having:
• a distal portion that is movable through the lumen of the segment, and
• a distal end defining a tube-opening, the distal end of the first tube being passable through a first opening in the segment;
• a first tissue anchor deliverable through the first tube;
• a second tube having:
• a distal portion, and
• a distal end defining a tube-opening, the distal end of the second tube being passable through a second opening in the segment;
• and
• a second tissue anchor deliverable through the second tube,
• wherein:
• the system has a first-tissue-anchor-delivery state in which, during penetrating of a first portion of tissue at the surface of the heart valve by the first tissue anchor, (1) the distal portion of the first tube is disposed within the first opening in the segment, and (2) the distal end of the first tube faces the first portion of tissue at the surface of the heart valve, and
• the system has a second-tissue-anchor-delivery state in which, during penetrating of a second portion of tissue at the surface of the heart valve by the second tissue anchor, (a) the distal portion of the second tube is disposed within the second opening in the segment, and (b) the distal end of the second tube faces the second portion of tissue at the surface of the heart valve.

An annuloplasty system comprising:

• a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart of a patient;
• a tube having:
• a distal portion that is movable through the lumen of the segment,
• a distal end passable through an opening in the segment that is in fluid communication with the lumen;
• and
• at least one tissue anchor deliverable through the tube, the tissue anchor being shaped so as to define a tissue coupling element,
• wherein, the distal portion of the tube is configured to be removably positioned within the lumen of the segment, and, while so positioned, to deploy the tissue coupling element from the distal end of the tube in order to penetrate the tissue coupling element into cardiac tissue in a direction parallel to a central longitudinal axis of the tube through the distal end of the tube.

A method for performing an annuloplasty on a heart valve of a heart of a patient, comprising:

• positioning a segment having a lumen therethrough in a vicinity of a surface of a heart valve of a heart of a patient;
• longitudinally moving a tube with respect to the segment such that:
• a distal end of a tube moves through a first opening in the segment that is in fluid communication with the lumen;
• and
• a distal portion of the tube moves through the lumen of the segment, wherein, during the longitudinal moving of the distal end of the tube through the first opening, the distal end of the tube faces a first portion of tissue of the heart valve;
• advancing a first tissue anchor through the distal end of the tube;
• anchoring the first tissue anchor to the first portion of the tissue while the distal end of the tube faces the first portion of the tissue;
• and
• subsequently, passing a second tissue anchor through a second opening in the segment and anchoring the second tissue anchor to a second portion of tissue of the heart valve.