Adjustable three-dimensional annuloplasty ring

A mitral annuloplasty ring and shape adjustment system, comprising:

• a three-dimensional annuloplasty ring defining a continuous peripheral shape around a central aperture, the annuloplasty ring having an inner core formed of an elastic-plastic material and a suture-permeable interface surrounding the inner core and extending around the peripheral shape, the inner core having an arcuate anterior segment that overlaps an arcuate posterior segment on opposite sides, the peripheral shape being a rounded D-shape in plan view wherein both the anterior segment and posterior segment rise up from the opposite sides to form a saddle shape, and the anterior and posterior segments define a ratchet mechanism at overlapped regions on opposite sides such that a position of the anterior segment relative to the posterior segment may be changed and the peripheral shape of the annuloplasty ring may be adjusted;
• a pair of adjustment filaments adapted to pass through passages in one of the segments of the inner core, the filaments being connected to and displace the other segment on opposite sides to adjust the peripheral shape of the annuloplasty ring;
• a plurality of anchoring sutures adapted to pass through the interface and secure the annuloplasty ring to a native heart valve annulus;
• and
• a shape adjusting mechanism including an access sheath having a length sufficient to extend from the native heart valve annulus through an access incision in the heart and out of the body, the pair of adjustment filaments passing through the access sheath, the shape adjusting mechanism having a pair of tension adjusters and each of the adjustment filaments passing separately through an associated one of the tension adjusters to enable separate displacement of the adjustment filaments relative to the annuloplasty ring, the access sheath having sufficient column strength such that tension on either of the adjustment filaments caused by the associated tension adjuster adjusts the peripheral shape of the annuloplasty ring.