Anti-winding delivery device, transcatheter shrinking ring system and its application

Abstract

The present application provides a delivery device, a transcatheter shrink ring system and its application for preventing entanglement. The delivery device is used to deliver an anchor assembly and a tightening wire. The delivery device includes a delivery sheath and a stopper. The wall of the delivery sheath is provided with a through groove extending from the distal end to the proximal end, the through groove is connected to the inner cavity of the delivery sheath, and the distal end of the through groove has an opening. The anchor assembly is movably mounted on the delivery sheath and connected to the tightening wire. The stopper is provided at the distal end of the delivery sheath, and the stopper is used to close the opening to separate the distal end of the anchor assembly from the tightening wire. In the delivery device provided by the present application, by providing a through groove and a stopper at the distal end of the delivery sheath, the portion of the tightening wire extending from the point where it is connected to the anchor assembly to the distal end can be located outside the delivery sheath, thereby preventing the tightening wire from being entangled with the portion of the anchor assembly located inside the delivery sheath, reducing or even eliminating the risk of entanglement, and facilitating the smooth implantation of the anchor assembly.

Description

Technical Field

[0001] The present application relates to the technical field of medical devices, and in particular to a wire-winding prevention delivery device, a catheter shrinking ring system including the wire-winding prevention delivery device, and applications thereof. Background Art

[0002] Mitral regurgitation (abbreviated as: MR) is a common heart valve disease, including primary mitral regurgitation and secondary mitral regurgitation. Primary mitral regurgitation is due to abnormal mitral valve leaflets, rupture of chordae tendineae or papillary muscle insufficiency, resulting in poor anastomosis of the anterior and posterior leaflets of the mitral valve. Secondary mitral regurgitation is due to valve ring dilatation, left atrial and left ventricular enlargement, resulting in poor anastomosis of the anterior and posterior leaflets of the mitral valve. In recent years, mitral valve interventional treatment has developed rapidly, mainly including valve repair or valve replacement. Among them, mitral annuloplasty is a common repair procedure that reduces the size of the patient's valve ring to reduce mitral regurgitation.

[0003] In the prior art, multiple anchors slidably connected to a cable are sequentially implanted into the mitral valve annulus via a transcatheter approach. The cable is then tightened to shorten the distance between the anchors on the annulus, circumferentially tightening the annulus and thereby alleviating mitral regurgitation. The distal end of the anchor is typically spiral-shaped or has a sharp tip, allowing the anchor to be implanted and embedded in the annular tissue. During the anchor delivery and implantation process, because the anchor is threaded onto the cable and both the anchor and the cable are delivered through the same delivery tube, the cable can easily become entangled with the distal end of the anchor, affecting the anchor's implantation and causing surgical failure. Summary of the Invention

[0004] In the first aspect, the present application proposes a conveying device for preventing winding of wires, which is used for conveying an anchor assembly and a tightening wire. The conveying device includes a conveying sheath and a stopper. The wall of the conveying sheath is provided with a through groove extending from the distal end to the proximal end, the through groove being connected to the inner cavity of the conveying sheath, and the distal end of the through groove has an opening. The anchor assembly is movably mounted on the conveying sheath and connected to the tightening wire. The stopper is provided at the distal end of the conveying sheath, and the stopper is used to close the opening to separate the distal end of the anchor assembly from the tightening wire.

[0005] In a second aspect, the present application provides a transcatheter shrink ring system, comprising an implant, an anchoring device, and the anti-winding delivery device as described above. The implant comprises the tightening wire and a plurality of the anchoring assemblies, the anchoring assembly being detachably connected to the distal end of the anchoring device and being passed through the delivery sheath, the delivery sheath being used to deliver the anchoring assembly and the tightening wire to the cardiac tissue, and the anchoring device being used to drive the anchoring assembly to anchor into the cardiac tissue. The distal end of the tightening wire is fixedly connected to the first anchoring assembly for anchoring into the cardiac tissue, and the proximal end of the tightening wire can slide through the other anchoring assemblies for anchoring into the cardiac tissue.

[0006] In a third aspect, the present application also provides an application of the transcatheter ring shrinkage system as described above, wherein the transcatheter ring shrinkage system is used to shrink the annular tissue during annuloplasty or to reduce the ventricular volume during ventricular volume reduction surgery.

[0007] The delivery device, transcatheter shrink ring system and application thereof provided by the present application are characterized in that a through groove extending from the distal end to the proximal end is opened in the wall of the delivery sheath, and a stop portion for closing the opening of the through groove is provided at the distal end of the delivery sheath. When the anchor assembly is installed in the delivery sheath and the tightening wire is connected, the anchor assembly is at least partially accommodated in the inner cavity of the delivery sheath, and the distal end of the anchor assembly is separated from the tightening wire by the stop portion. In this way, the portion of the tightening wire extending from the point where it is connected to the anchor assembly to the distal end is located outside the delivery sheath, thereby preventing the tightening wire and the portion of the anchor assembly located in the inner cavity of the delivery sheath from getting entangled, avoiding the risk of winding, and facilitating the smooth implantation of the anchor assembly. BRIEF DESCRIPTION OF THE DRAWINGS

[0008] In order to more clearly illustrate the technical solutions of the implementation methods of the present application, the following is a brief introduction to the drawings required for use in the implementation methods. Obviously, the drawings described below are some implementation methods of the present application. For ordinary technicians in this field, other drawings can be obtained based on these drawings without any creative work.

[0009] Figure 1 It is a structural schematic diagram of a transcatheter shrink ring system provided in one embodiment of the present application.

[0010] Figure 2 This is a schematic diagram of an implant provided by one embodiment of the present application being implanted into the valve ring and the tightening line not being tightened.

[0011] Figure 3 yes Figure 2 Schematic diagram of the tightening line after tightening.

[0012] Figure 4 This is a schematic diagram of the three-dimensional structure of an anchoring assembly provided in one embodiment of the present application, which is installed at the distal end of a delivery sheath.

[0013] Figure 5 yes Figure 4 An enlarged schematic diagram of part V in FIG.

[0014] Figure 6 This is a schematic diagram of the three-dimensional structure of an anchoring assembly provided in another embodiment of the present application that is installed at the distal end of a delivery sheath.

[0015] Figure 7 yes Figure 6 An enlarged schematic diagram of part VII.

[0016] Figure 8 It is a structural schematic diagram of the anchoring assembly provided in one embodiment of the present application.

[0017] Figure 9 yes Figure 8 Schematic diagram of the three-dimensional decomposition structure of the anchor component.

[0018] Figure 10 It is a schematic diagram of the three-dimensional structure of the anchoring assembly provided in another embodiment of the present application.

[0019] Figure 11 This is a schematic diagram of the connection between the conveying member, the tightening line and the first anchoring component provided in one embodiment of the present application.

[0020] Figure 12 This is a schematic diagram of the three-dimensional exploded structure of the delivery sheath, anchoring assembly and tightening wire provided in one embodiment of the present application.

[0021] Figure 13 It is a schematic diagram of the three-dimensional structure in which the distal end of the stop wire (i.e., the stop portion) is inserted into the wire threading groove of the sleeve.

[0022] Figure 14 It is a schematic diagram of the three-dimensional structure in which the anchoring component partially penetrates into the casing.

[0023] Figure 15 This is a schematic diagram of the three-dimensional structure of an anchoring assembly provided in another embodiment of the present application, which is installed on the distal end of the delivery sheath.

[0024] Figure 16 yes Figure 15 A schematic diagram of the blocking wire (i.e., the stopper) being withdrawn toward the proximal end to the distal end without closing the opening of the through groove.

[0025] Figure 17 This is a schematic diagram of the three-dimensional structure of an anchoring assembly provided in another embodiment of the present application, which is installed on the distal end of a delivery sheath.

[0026] Figure 18 This is a schematic diagram of the connection between the anchoring assembly and the anchoring device provided in one embodiment of the present application.

[0027] Figure 19 yes Figure 18 Schematic diagram of the separation of the anchoring component and the anchoring device.

[0028] Figure 20 yes Figure 18 An axial cross-sectional view of the anchor assembly when connected to the anchor device.

[0029] Figure 21 This is an axial cross-sectional view of an anchoring device provided by one embodiment of the present application installed in a delivery device.

[0030] Figure 22 It is a schematic diagram of a pusher pushing a spacer.

[0031] Figure 23 Schematic diagram of the delivery sheath pushing the spacer.

[0032] Figure 24 It is a schematic diagram of the three-dimensional structure of the tightening line passing through the wire take-up device.

[0033] Figure 25 yes Figure 24 Schematic diagram of the three-dimensional structure of the wire take-up with the proximal end portion removed from its housing.

[0034] Figure 26 It is a schematic diagram of the three-dimensional structure of the winding shaft, the limiting column, the anti-rotation wheel and the elastic part.

[0035] Figure 27 It is an axial cross-sectional view of the detachable connection between the wire take-up and the distal end of the adjustment device.

[0036] Figures 28 to 32 This is a schematic diagram of the use process of the transcatheter shrink ring system provided in one embodiment of the present application.

[0037] The following specific implementation methods will further illustrate the present application in conjunction with the above-mentioned drawings. DETAILED DESCRIPTION

[0038] The following will be combined with the drawings in the embodiments of this application to clearly and completely describe the technical solutions in the embodiments of this application. Obviously, the embodiments described are only part of the embodiments of this application, not all of the embodiments. Based on the embodiments of this application, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of this application.

[0039] In addition, the following descriptions of the various embodiments refer to the accompanying illustrations to illustrate specific embodiments that may be implemented in the present application. Directional terms mentioned in this application, such as "upper," "lower," "front," "back," "left," "right," "inner," "outer," and "side," are only used with reference to the directions in the accompanying illustrations. Therefore, the directional terms used are intended to better and more clearly illustrate and understand the present application, and are not intended to indicate or imply that the devices or components referred to must have a specific orientation, be constructed, or operate in a specific orientation. Therefore, they should not be understood as limitations on the present application.

[0040] It should be noted that, in order to more clearly describe the structure of the anti-winding delivery device and transcatheter shrink ring system provided by this application, the limiting terms "proximal end" and "distal end" described in this specification are commonly used terms in the field of interventional medicine. Specifically, "distal end" refers to the end away from the operator during the surgical procedure, and "proximal end" refers to the end close to the operator during the surgical procedure; the direction of the rotation center axis of an object such as a cylinder or a tube is defined as the axial direction; the circumferential direction is the direction around the axis of an object such as a cylinder or a tube (perpendicular to the axis and also perpendicular to the cross-sectional radius); and the radial direction is the direction along the diameter or radius.

[0041] It is worth noting that the "end" appearing in the terms "proximal end", "distal end", "one end", "the other end", "first end", "second end", "initial end", "terminal end", "two ends", "free end", "upper end", "lower end", etc. is not limited to the end head, endpoint or end face, but also includes a portion extending from the end head, endpoint or end face to an axial distance and / or radial distance on the element to which the end head, endpoint or end face belongs. Unless otherwise defined, all technical and scientific terms used in this application have the same meaning as commonly understood by technicians in the technical field to which this application belongs. The customary terms used in the specification of this application are only for the purpose of describing specific embodiments and are not to be understood as limiting this application.

[0042] See also Figures 1 to 3 The present application provides a transcatheter ring reduction system 1, which can be used to implant multiple anchoring components 34 connected by tightening wires 32 in cardiac tissues such as the mitral valve annulus or the tricuspid valve annulus. By tightening the tightening wires 32, the spacing between the multiple anchoring components 34 can be reduced to directly reduce the valve annulus, thereby achieving treatment of mitral valve regurgitation or tricuspid valve regurgitation.

[0043] In the present application, the transcatheter ring reduction system 1 includes an anchoring device 10 , an implant 30 , a delivery device 50 and an introduction device 70 .

[0044] See also Figure 1In some embodiments, the guide device 70 includes a first guide sheath 71 and a second guide sheath 72 installed in the first guide sheath 71. The second guide sheath 72 can extend from the distal end of the first guide sheath 71 and fit on the valve ring, thereby establishing an interventional channel from the outside of the body to the heart.

[0045] Preferably, both the first guide sheath 71 and the second guide sheath 72 are adjustable bend sheaths, allowing the distal end of the guide device 70 to be adjusted to an angle that fits the valve annulus. The two adjustable bend guide sheaths can better adjust the bending angle and direction of the distal end of the guide device 70. In other embodiments, the guide device 70 may utilize only one adjustable bend guide sheath. Adjustable bend guide sheaths are commonly used in interventional procedures in the prior art and are not described in detail here.

[0046] Please combine Figure 2 and Figure 3 In some embodiments, the implant 30 includes a tightening wire 32 and a plurality of anchoring components 34, wherein the plurality of anchoring components 34 are connected by the tightening wire 32 and are respectively used to be anchored into the valve annulus. Figure 1 As shown, each anchoring assembly 34 is detachably connected to the distal end of the anchoring device 10, and the anchoring device 10 is used to implant the anchoring assembly 34 into the valve annulus.

[0047] The delivery device 50 is used to deliver the implant 30 to the valve annulus. The delivery device 50 includes a delivery sheath 51. The anchoring assembly 34 is detachably connected to the distal end of the anchoring device 10 and is inserted into the delivery sheath 51. The anchoring device 10 is inserted into the inner cavity of the delivery sheath 51. The delivery sheath 51 is used to deliver the anchoring assembly 34 and the tightening wire 32 to the valve annulus. The anchoring device 10 is used to drive the anchoring assembly 34 to anchor into the valve annulus. The distal end of the delivery sheath 51 is flexible. The delivery sheath 51 is inserted into the inner cavity of the second guide sheath 72. The distal end of the delivery sheath 51 can be driven to bend by adjusting the bending angle of the distal end of the guide device 70.

[0048] Each anchoring assembly 34 comprises an anchor 340 for anchoring into the annulus and a threading structure disposed on the anchor 340. The anchor 340 is inserted into the distal lumen of the delivery sheath 51. The distal end of the tightening wire 32 is fixedly connected to the threading structure of the first anchoring assembly 34 anchored into the annulus, while the proximal end of the tightening wire 32 slides through the threading structure of the other anchoring assemblies 34 anchored into the annulus. In this way, the tightening wire 32 is connected to the anchor 340 via the threading structure, thereby connecting multiple anchoring assemblies 34 anchored into the annulus in series. Tightening the tightening wire 32 reduces the spacing between the multiple anchoring assemblies 34, thereby achieving annular contraction.

[0049] When using the transcatheter ring reduction system 1 for ring reduction, an interventional channel is first established from the patient's body to the heart through the guide device 70, and then the delivery sheath 51 equipped with the anchoring device 10 and the anchoring assembly 34 is moved axially distally in the inner cavity of the second guide sheath 72 of the guide device 70 together with the tightening wire 32 until the delivery sheath 51 abuts against the valve annulus, and then the anchoring device 10 drives the anchoring assembly 34 to anchor into the valve annulus in the delivery sheath 51. Multiple anchoring assemblies 34 are anchored into different positions along the circumference of the valve annulus (such as Figure 2 As shown), by tightening the tightening wire 32 to adjust the spacing between the multiple anchoring components 34, the multiple anchoring components 34 are relatively gathered (as shown in FIG. Figure 3 As shown), the valve ring is driven to contract, thus achieving the purpose of ring shrinkage.

[0050] It is important to note that please refer to Figures 4 to 7 The delivery sheath 51 has a through slot 512 extending proximally from its distal end. The through slot 512 communicates with the inner lumen of the delivery sheath 51 and has an opening at its distal end. The delivery device 50 also includes a stopper 55 disposed at the distal end of the delivery sheath 51. The stopper 55 is configured to close the distal opening of the through slot 512, thereby separating the distal end of the anchor assembly 34 from the tensioning wire 32.

[0051] It can be understood that in the delivery device 50 provided in the present application, a through groove 512 extending from the distal end to the proximal end is opened in the wall of the delivery sheath 51, and a stop portion 55 for closing the distal opening of the through groove 512 is provided at the distal end of the delivery sheath 51. When the anchor assembly 34 is installed in the delivery sheath 51 and connected to the tightening line 32, at least a portion of the anchor assembly 34 (such as the anchor 340) is accommodated in the inner cavity of the delivery sheath 51, and the distal end of the anchor assembly 34 is separated from the tightening line 52 by the stop portion 55. In this way, the portion of the tightening line 32 extending distally from the point where it is connected to the anchor assembly 34 is located outside the delivery sheath 51, thereby preventing the tightening line 32 from being entangled with the portion of the anchor assembly 34 located in the inner cavity of the delivery sheath 51 (i.e., the anchor 340), avoiding the risk of winding, and facilitating the smooth implantation of the anchor assembly 34.

[0052] Optionally, the proximal end of the through slot 512 can be closed, or it can extend along the axial direction of the delivery sheath 51 to penetrate the proximal end of the delivery sheath 51. Preferably, the proximal end of the through slot 512 is closed, and the through slot 512 does not penetrate the opposite ends of the delivery sheath 51, so that the structural strength of the delivery sheath 51 is high.

[0053] See also Figure 5 and Figure 7In some embodiments, the threading structure of the anchor assembly 34 is at least partially exposed from the through slot 512 and located outside the delivery sheath 51, and the tightening wire 32 is connected to the portion of the threading structure located outside the delivery sheath 51. In this way, the radial dimension of the delivery sheath 51 can be reduced. It can be understood that the threading structure of the anchor assembly 34 is at least partially exposed from the through slot 512, that is, the threading structure is partially located within the lumen of the delivery sheath 51 and partially located outside the delivery sheath 51; or the threading structure is entirely located outside the delivery sheath 51. The threading structure is at least partially exposed from the through slot 512, and the tightening wire 32 can be connected to the portion of the threading structure located outside the delivery sheath 51, which is simple to connect. The tightening wire 32 is entirely located outside the delivery sheath 51. Of course, the portion of the tightening wire 32 extending proximally from the point where it is connected to the threading structure can also be located within the lumen of the delivery sheath 51.

[0054] In other embodiments, the threading structure of the anchor assembly 34 can be entirely located within the lumen of the delivery sheath 51, that is, the anchor assembly 34 is entirely located within the lumen of the delivery sheath 51, and the tightening wire 32 passes through the through slot 512 into the lumen of the delivery sheath 51 and is connected to the threading structure of the anchor assembly 34. The connection between the tightening wire 32 and the anchor assembly 34 is located within the lumen of the delivery sheath 51, and the remaining portion of the tightening wire 32 can be located outside the delivery sheath 51.

[0055] See also Figures 8 to 10 In some embodiments, the anchoring member 340 includes an anchoring portion 341 and an anchoring seat 343 connected to the proximal end of the anchoring portion 341. The anchoring seat 343 is used to be detachably connected to the distal end of the anchoring device 10, and the anchoring portion 341 is used to anchor into the heart tissue valve ring so that the anchoring assembly 34 is implanted on the valve ring. Figures 8 to 10 In the example shown, the anchoring portion 341 is a helical anchor with a pointed tip, which is easily anchored into cardiac tissue such as the valve annulus, and the anchoring assembly 34 is not easily dislodged after implantation. In other embodiments, the anchoring portion 341 may have another suitable structure that enables the anchoring portion 341 to engage with and be substantially fixed to tissue, such as, but not limited to, barbs, hooks, or tines. To facilitate delivery, the barbs or hooks are at least partially made of a material having shape memory.

[0056] In some embodiments, the threading structure of the anchor assembly 34 includes a connector 345 movably mounted on the anchor seat 343 and a threading ring 347 movably connected to the connector 345, and the tightening wire 32 is connected to the threading ring 347. Figure 5 and Figure 7 As shown, the threading ring 347 is at least partially exposed from the through groove 512 and is located outside the delivery sheath 51, the tightening wire 32 is connected to the part of the threading ring 347 located outside the delivery sheath 51, and the tightening wire 32 is located outside the delivery sheath 51 as a whole.

[0057] In other embodiments, the connector 345 can also be movably mounted on the proximal end of the anchor portion 341. The anchor portion 341 can be designed as a spiral anchor, or a retaining member can be provided on the anchor portion 341 to prevent the connector 345 from falling off the anchor 340. Of course, the threading structure of the anchor assembly 34 can also include only a threading ring 347 mounted on the anchor 340. Preferably, the threading ring 347 can be movably mounted on the anchor seat 343. The threading structure can also be a threading hole opened on the anchor 340. Preferably, the threading hole can be provided on the anchor seat 343.

[0058] It should be noted that if Figure 11 As shown, the tightening wire 32 is connected to the anchoring assembly 34 by connecting the threading ring 347. The distal end of the tightening wire 32 is fixedly connected to the first anchoring assembly 34 for anchoring into the valve annulus, and the proximal end of the tightening wire 32 can slide through the threading ring 347 of the other anchoring assembly 34 for anchoring into the valve annulus. Specifically, after the tightening wire 32 passes through the threading ring 347 of the first anchoring assembly 34 for anchoring into the valve annulus, it is folded in half and the distal end of the tightening wire 32 is fixed by the pressing tube 33, and the pressing tube 33 cannot pass through the threading ring 347. The pressing tube 33 can be made of a metal material with good biocompatibility (for example, but not limited to stainless steel) and is extruded by a press to fix the distal end of the tightening wire 32. Preferably, the pressing tube 33 is entirely wrapped with a film to reduce the risk of damage to heart tissue such as the valve annulus by the pressing tube 33.

[0059] Please refer again Figure 5 In some embodiments, the radial width of the through-slot 512 is greater than the axial thickness of the threading ring 347 (i.e., the thickness of the threading ring 347 in the axial direction), allowing the threading ring 347 to at least partially emerge from the through-slot 512 and be located outside the delivery sheath 51. The tightening wire 32 is connected to the portion of the threading ring 347 located outside the delivery sheath 51. After the tightening wire 32 is connected to the threading ring 347, it can be located entirely outside the delivery sheath 51. Furthermore, the radial width of the through-slot 512 is smaller than the maximum outer diameter of the threading ring 347 to prevent the through-slot 512 from being too wide, which would prevent the threading ring 347 from easily falling into the inner lumen of the delivery sheath 51 during delivery of the anchor assembly 34.

[0060] In some embodiments, the axial length of the through slot 512 is greater than the maximum outer diameter of the threading ring 347, so that the entire threading ring 347 can be exposed from the through slot 512. The threading ring 347 is located outside the delivery sheath 51, and the threading space is larger, which is more conducive to the tightening wire 32 passing through the threading ring 347, making the connection operation easier. Figure 5 and Figure 7 In the example, the axial length of the through slot 512 is greater than the axial distance H between the proximal end of the connecting member 345 and the distal end of the anchoring portion 341 (see Figure 11), so that the entire anchoring component 340 can be accommodated in the inner cavity of the delivery sheath 51, and the anchoring component 340 and the tightening line 32 are completely isolated from the inner and outer sides of the delivery sheath 51, which is more conducive to avoiding the problem of winding of the anchoring component 34 during the delivery and implantation process.

[0061] In some embodiments, the distal opening of the through slot 512 is chamfered or rounded, so that the distal opening of the through slot 512 is flared. It is understood that during the process of threading the anchor assembly 34 into the distal end of the delivery sheath 51, when the threading loop 347 is partially located in the lumen of the delivery sheath 51 and partially located outside the delivery sheath 51, the flared distal opening is more conducive to the threading loop 347 entering the through slot 512, thereby facilitating the assembly of the anchor assembly 34.

[0062] Please refer again Figures 8 to 10 In some embodiments, the anchor seat 343 includes a seat body 3433, a first connecting portion 3431 and a plug-in portion 3437 connected to the proximal and distal ends of the seat body 3433, respectively, and a support block 3435 fixedly connected to the plug-in portion 3437. A support portion is provided between the distal end of the seat body 3433 and the proximal end of the plug-in portion 3437. The distal end surface of the seat body 3433 abuts the proximal end surface of the support portion, while the proximal end surface of the support block 3435 abuts the distal end surface of the support portion. The outer diameters of the seat body 3431 and the support block 3435 are approximately equal and larger than the outer diameter of the support portion. Therefore, the seat body 3431, the support portion, and the support block 3435 form a roughly "I"-shaped structure and form an annular connecting groove. When the connecting member 345 is mounted on the anchor seat 343, the connecting member 345 is at least partially received in the connecting groove.

[0063] Among them, the first connecting portion 3431 is used for detachable connection with the distal end of the anchoring device 10. The plug-in portion 3437 is used to connect the proximal end of the anchoring portion 341. Specifically, the plug-in portion 3437 is provided with a plug-in hole extending along the axial direction of the anchoring member 340, and the proximal end of the anchoring portion 341 is plugged into the plug-in hole and fixed by welding or gluing. In other embodiments, the anchoring portion 341 can be directly fixedly connected to the plug-in portion 3437 by welding or the like, and the plug-in portion 3437 does not need to be provided with a plug-in hole. Of course, the anchoring portion 341 can also be directly fixedly connected to the distal end surface of the support block 3435 by welding or the like, and the support block 3435 is directly fixedly connected to the proximal end surface of the support portion at the proximal end of the seat body 3433, so that the plug-in portion 3437 does not need to be provided.

[0064] See also Figure 9In some embodiments, the connector 345 is provided with an assembly hole 3452 and a connection hole 3454. The anchor seat 343 is inserted into the assembly hole 3452. Specifically, the connector 345 is movably mounted on the support portion of the anchor seat 343 through the assembly hole 3452. The connection hole 3454 is used to movably connect the threading ring 347. The threading ring 347 passes through the connection hole 3454 of the connector 345, thereby being buckled with the connector 345, thereby realizing a movably connected threading ring 347 and the connector 345. Figure 8 and Figure 9 In the example of , the connecting hole 3454 extends radially along the anchor 340. Figure 10 In the example of FIG, the connecting hole 3454 extends along the axial direction of the anchor 340. In other embodiments, the connecting member 345 may be a connecting ring that is directly buckled with the threading ring 347.

[0065] Among them, the diameter of the assembly hole 3452 is larger than the diameter of the support portion of the anchor seat 343 and smaller than the maximum outer diameter of the anchor seat 343 (i.e., the outer diameter of the seat body 3433 and the support block 3435), so that the connector 345 can be movably mounted on the anchor seat 343 and will not fall off the anchor seat 343. The threading ring 347 can be a circular ring or an elliptical ring, and the shape of its axial cross-section can also be circular or elliptical. The assembly hole 3452 and the connecting hole 3454 of the connector 345 can be circular holes or elliptical holes. In some examples, the threading ring 347 is a circular ring, and its axial cross-section is also circular; the assembly hole 3452 and the connecting hole 3454 of the connector 345 are both circular holes.

[0066] In some embodiments, the connector 345 can be arranged around the central axis Z of the anchor 340 (see FIG. Figure 8 and Figure 10 ) rotates 360 degrees, that is, the connector 345 has a rotational freedom of rotation about the central axis Z of the anchor 340. Furthermore, the axial width of the connecting groove of the anchor seat 343 can be greater than the axial thickness of the mounting portion 3451, preferably 2-3 times the axial thickness of the mounting portion 3451, so that the connector 345 can move axially along the anchor 340, that is, the connector 345 also has a translational freedom of movement along the central axis Z of the anchor 340. Thus, the connector 345 has two degrees of freedom: a rotational freedom of rotation about the central axis Z of the anchor 340 and a translational freedom of movement along the central axis Z of the anchor 340. Of course, in other embodiments, the connector 345 may have a single degree of freedom, namely, a rotational freedom of rotation about the central axis Z of the anchor 340.

[0067] It will be appreciated that after the multiple anchoring assemblies 34 are anchored into the annulus, the connector 345 can rotate about the central axis Z of the anchor 340, allowing the threading ring 347, which is fastened to the connector 345, to move to a position that matches the tightened tightening wire 32 under the tension of the tightening wire 32. The threading ring 347 is movably connected to the connector 345, and the threading direction of the threading ring 347 can be along the circumference of the annulus, thereby greatly reducing the resistance to the contraction of the tightening wire 32, preventing the tightening wire 32 from bending and ensuring smooth and stable contraction. Furthermore, the connector 345 can move axially along the anchor 340. If the anchoring depths of the anchoring portions 341 of the multiple anchoring assemblies 34 are inconsistent, the tightening wire 32 can pull the connector 345 up and down along the axial direction, further reducing the bending of the tightening wire 32 and ensuring that the tightening wire 32 is distributed as much as possible on the same plane, ensuring smooth and stable contraction. The threading ring 347 is movable and can be adjusted in direction with the connector 345 to further reduce the contraction resistance of the tightening wire 32. Furthermore, since the resistance experienced by the tightening wire 32 in the tightening direction is greatly reduced, the tightening force is reduced and the tightening force is more evenly distributed on each anchoring assembly 34. Consequently, the force experienced by each anchoring assembly 34 is also greatly reduced, reducing the force exerted by the anchoring assembly 34 on the annulus and the risk of damage to the annulus. This also prevents a situation where a single anchoring assembly 34 experiences a larger share of the tightening force, reducing the risk of the anchoring assembly 34 falling off and making implantation safer.

[0068] Please refer again Figure 8 and Figure 10 In some embodiments, a clamping end 3455 is provided on the side of the connector 345 away from the anchor seat 343. The radial width of the clamping end 3455 matches the radial width of the through slot 512. When the anchor assembly 34 is inserted into the distal end of the delivery sheath 51, the clamping end 3455 is clamped in the through slot 512. This prevents the connector 345 from rotating during the delivery of the anchor assembly 34, thereby driving the threading ring 347 to rotate and ensuring stable and smooth delivery of the anchor assembly 34. Figure 5 In the example, when the anchor assembly 34 is installed on the distal end of the delivery sheath 51, the clamping end 3455 is clamped in the through groove 512, and the threading ring 347 is partially exposed from the through groove 512 and is located outside the delivery sheath 51. Figure 7 In the example, when the anchoring assembly 34 is installed on the distal end of the delivery sheath 51 , the clamping end 3455 is clamped in the through groove 512 , and the threading ring 347 is exposed from the through groove 512 as a whole and is located outside the delivery sheath 51 .

[0069] Furthermore, a connecting hole 3454 is formed at the retaining end 3455 and extends radially along the anchor member 340. A guide ramp 3456 is provided on the retaining end 3455 protruding proximally along the axial direction of the anchor member 340. When the anchor assembly 34 is released from the delivery sheath 51 and needs to be retracted into the delivery sheath 51 to reselect an anchor point if the anchor assembly 34 is not properly positioned, the provision of the guide ramp 3456 facilitates the retraction of the anchor assembly 34 into the delivery sheath 51, preventing the anchor assembly 34 from becoming stuck during retraction.

[0070] It should be noted that, to ensure safety after implantation, the anchor assembly 34 is made entirely of a material with good biocompatibility, including but not limited to metal materials (e.g., stainless steel) or polymer materials (e.g., PEEK, PET). The anchor seat 343 and the anchor portion 341 are preferably made of stainless steel with a relatively high hardness. Both the connector 345 and the threading ring 347 can be made of stainless steel or polymer materials (e.g., PEEK, PET), preferably of a flexible polymer material that can be twisted and deformed, thereby facilitating rotation.

[0071] See also Figure 5 and Figure 7 In some embodiments, a stopper 55 is movably disposed at the distal end of the delivery sheath 51. The stopper 55 opens the distal opening of the through-slot 512 to allow the anchor assembly 34 to be movably inserted into the delivery sheath 51. When the anchor assembly 34 is delivered, the stopper 55 closes the distal opening of the through-slot 512. The stopper 55 is movably disposed at the distal end of the delivery sheath 51, and is particularly suitable for situations where the threading structure of the anchor assembly 34 (particularly the threading ring 347) is at least partially exposed from the through-slot 512 and located outside the delivery sheath 51. By controlling the stopper 55 to open the distal opening of the through-slot 512, the threading structure of the anchor assembly 34 can slide from the opening into the through-slot 512, thereby allowing the selection of a delivery sheath 51 with a smaller radial dimension.

[0072] Specifically, the proximal end of the stopper 55 extends axially along the delivery sheath 51, while the distal end of the stopper 55 conforms to the circumference of the delivery sheath 51 and, when not subject to external forces, closes the distal opening of the through-slot 512. It will be appreciated that the stopper 55 is an elongated member, with at least the distal end of the stopper 55 being made of a material having a shape memory function (such as, but not limited to, nickel titanium, a nickel-titanium alloy, etc.). In other words, the distal end of the stopper 55 is made of a material having a shape memory function, or the entire stopper 55 is made of a material having a shape memory function. Preferably, the distal end of the stopper 55 is a non-closed loop in its natural state, providing good guidance and easy retraction of the stopper 55. This increases the travel range of the stopper 55, ensures that the distal end of the stopper 55 can pass through the through-slot 512 to form a blocking effect, and securely and stably closes the distal opening of the through-slot 512. Furthermore, this ensures that the stopper 55 is sufficiently strong and not prone to breakage. Of course, the distal end of the stopper 55 in the natural state may also be an arc segment adapted to the circumference of the delivery sheath 51. It should be noted that the natural state means that the stopper 55 is not subjected to any external force.

[0073] like Figures 4 to 7 As shown, in a feasible embodiment, the stopper 55 can be a stopper wire that is movably inserted into the tube wall or inner cavity of the delivery sheath 51. The stopper wire can be made of nickel-titanium wire, and its distal end is formed into a non-closed loop by heat setting treatment. It can be understood that the distal end of the stopper wire closes the distal opening of the through groove 512 when it is not subjected to external force. Due to the stopping of the stopper wire, the threading structure of the anchor assembly 34 cannot slide out from the distal opening of the through groove 512, thereby preventing the anchor assembly 34 from detaching from the delivery sheath 51 during the delivery process, so as to ensure that the anchor 340 of the anchor assembly 34 is always in the inner cavity of the delivery sheath 51 during the delivery process, and avoid the tightening line 32 and the anchor 340 from being entangled. The radial cross-sectional shape of the stopper wire can be circular, oblate, rectangular, square or other shapes, etc., and this application does not make specific restrictions on this.

[0074] Furthermore, in other embodiments, the stopper 55 may be fixedly disposed at the distal end of the delivery sheath 51 to close the distal opening of the through-slot 512. For example, in one feasible embodiment, the stopper 55 may be a blocking piece fixed to the distal opening of the through-slot 512 by bonding, welding, or the like. The blocking piece extends radially along the delivery sheath 51 to cross the through-slot 512, such that the blocking piece closes the distal opening of the through-slot 512.

[0075] The following takes the example where the anchoring assembly 34 is installed in the delivery sheath 51, its threading ring 347 is located outside the delivery sheath 51 as a whole, and the stopper 55 is a wire stop to further illustrate the structure of the delivery device 50 provided in the present application.

[0076] Please also refer to Figure 7 、 Figures 12 to 14In some embodiments, the delivery device 50 further includes a cannula 57 fixedly nested in the inner cavity of the distal end of the delivery sheath 51. The cannula 57 includes a tubular body 571 and an annular portion 574 disposed at the distal end of the tubular body 571. The annular portion 574 has an annular channel 5741. The proximal end of the retaining wire (i.e., the stopper 55) movably extends axially within the wall or inner cavity of the delivery sheath 51, and the distal end of the retaining wire movably passes through the annular channel 5741.

[0077] like Figure 7 and Figure 14 As shown, in order to enable the threading structure of the anchor assembly 34 to enter the through groove 512 from the distal opening of the through groove 512, a narrow groove 572 is provided in the tube body 571 corresponding to the through groove 512, and a notch is provided in the annular portion 574 corresponding to the narrow groove 572. The size of the notch in the annular portion 574 is preferably consistent with the radial width of the narrow groove 572. In a natural state, that is, when the retaining wire is not subjected to external force, the distal end of the retaining wire is inserted into the annular channel 5741 and passes through the notch in the annular portion 574, so that the notch in the annular portion 574 is closed, that is, the distal openings of the through groove 512 and the narrow groove 572 are closed. When the anchor assembly 34 is inserted into the delivery sheath 51, pulling the retaining wire toward the proximal end can open the notch in the annular portion 574, that is, open the distal openings of the through groove 512 and the narrow groove 572 to insert the anchor assembly 34 into the delivery sheath 51. When the anchor assembly 34 is delivered, the pulling force on the retaining wire is released, and the distal end of the retaining wire returns to its original position due to its own memory function and closes the distal end opening of the through slot 512 again.

[0078] The axial length of the tube body 571 is greater than or equal to the axial length of the anchor assembly 34, and the radial width of the narrow groove 572 is greater than or equal to the radial width of the through groove 512, so that the anchor 340 of the anchor assembly 34 can be completely accommodated in the sleeve 57, and the clamping end 3455 of the connecting member 345 of the anchor assembly 34 passes through the notch of the annular portion 574 and the narrow groove 572 of the tube body 571 and is clamped in the through groove 512, so that the threading ring 347 is exposed from the narrow groove 572 and the through groove 512 and is located as a whole outside the delivery sheath 51. The anchor 340 is installed in the distal inner cavity of the delivery sheath 51 by being installed in the sleeve 57 nested in the distal inner cavity of the delivery sheath 51. The shape of the annular channel 5471 is adapted to the non-closed loop at the distal end of the stop wire, so that the stop wire can move smoothly without obstruction when opening or closing the distal opening of the through groove 512.

[0079] The tubular body 571 can be made of a metal material (such as, but not limited to, stainless steel) and inserted into the distal lumen of the delivery sheath 51, and fixed by welding, gluing, or hot-melting. In some embodiments, a plurality of welding holes are provided on the wall of the tubular body 571, and the tubular body 571 is preferably fixed to the delivery sheath 51 by hot-melting. The welding holes provided on the tubular body 571 make the welding of the tubular body 571 and the delivery sheath 51 more efficient and provide a better connection effect.

[0080] See also Figure 12 and Figure 13 In some embodiments, the annular portion 574 includes an annular seat body 5742 provided at the distal end of the tube body 571 and an annular seat cover 5744 cooperatively connected to the annular seat body 5742, and an annular channel 5741 is formed between the annular seat body 5742 and the annular seat cover 5744. The annular seat cover 5744 has a notch corresponding to the narrow groove 572, so that the annular portion 574 has a notch corresponding to the narrow groove 572. Preferably, the notch size of the annular portion 574 is less than 1 / 3 of the length of the annular channel 5741, that is, the notch size of the annular portion 574 is less than 1 / 3 of the length of the non-closed loop at the distal end of the stop wire, and specifically preferably 1 / 6. The notch size of the annular portion 574 is reasonably set to ensure that the stop wire can close the notch of the annular portion 574, thereby closing the distal openings of the through groove 512 and the narrow groove 572, and at the same time making the distal resetting of the stop wire easier and more stable.

[0081] See also Figure 13 In some embodiments, the tube wall or inner cavity of the delivery sheath 51 is provided with a stop channel (not shown) in the axial direction, and the tube body 571 is provided with a wire threading groove 5711 connecting the stop channel and the annular channel 5741. The proximal end of the blocking wire moves through the wire threading groove 5711 and extends along the axial direction of the stop channel, and then extends outside the patient's body. Among them, the distal end of the wire threading groove 5711 is arc-shaped and connected to the annular channel 5471, and the proximal end of the wire threading groove 5711 is connected to the stop channel. The distal end of the wire threading groove 5711 is set to an arc shape, so that the blocking wire moves smoothly between the wire threading groove 5711 and the annular channel 5471. Furthermore, the sleeve 57 also includes a cover plate 577, which is a curved sheet structure as a whole and is fixedly connected to the tube body 571 by welding or the like. The cover plate 577 is used to limit the blocking wire to move in the wire threading groove 5711, thereby enhancing the retraction performance of the blocking wire.

[0082] In addition, the distal end of the delivery sheath 51 is further provided with a docking piece 59. The docking piece 59 is cylindrical in shape, and its distal end can be spot-welded to the proximal end of the tubular body 571, while its proximal end can be melt-bonded to the delivery sheath 51 using polyether block polyamide, thereby enhancing the connection strength between the tubular body 571 and the delivery sheath 51.

[0083] It can be understood that the proximal end of the blocking wire moves through the wire threading groove 5711 and extends proximally in the stop channel of the delivery sheath 51. The blocking wire remains straight in the stop channel and extends to the outside of the patient's body. By pulling or releasing the blocking wire, the gap of the annular portion 574 is opened or closed, thereby opening or closing the through groove 512 and the distal opening of the narrow groove 572. When the distal end of the delivery sheath 51 reaches the predetermined treatment site of the valve annulus, the stop wire is pulled toward the proximal end so that the distal end of the stop wire is moved away from the gap of the annular portion 574, that is, the distal openings of the through groove 512 and the narrow groove 572 are opened. At this time, the anchoring device 10 installed in the delivery sheath 51 can be used to push the anchoring assembly 34 to be released from the distal end of the delivery sheath 51 and drive the anchoring assembly 34 to be anchored into the valve annulus through the anchoring device 10; when the pulling force on the stop wire is released, the distal part of the stop wire returns to its original position under the action of its own memory function and closes the gap of the annular portion 574 again, that is, closes the distal openings of the through groove 512 and the narrow groove 572.

[0084] See also Figures 15 to 17 In some embodiments, a stop channel is provided in the wall or inner cavity of the delivery sheath 51 along the axial direction, and the distal end of the stop channel penetrates the wall of the delivery sheath 51 and is located on one side of the through slot 512 in the radial direction. A stop wire (i.e., the stop portion 55) is movably installed in the stop channel, and the distal end of the stop wire extends from the distal end of the stop channel, forming a loop to close the distal end opening of the through slot 512 (e.g., Figure 15 When the distal end of the delivery sheath 51 reaches the predetermined treatment site of the valve ring, the retaining wire is pulled toward the proximal end to move the distal end of the retaining wire away from the notch of the annular portion 574, thereby opening the distal end opening of the through slot 512 (as shown). Figure 16 In this embodiment, the delivery device 50 may not be provided with the sleeve 57, thereby simplifying the structure of the delivery device 50.

[0085] Furthermore, if Figure 17 As shown, the outer peripheral wall of the distal end of the delivery sheath 51 can be provided with an annular sleeve 58, which has a notch corresponding to the through groove 512. An annular slot is formed between the distal peripheral wall of the delivery sheath 51 and the annular sleeve 58. The distal end of the stop channel is connected to the annular slot, and the distal end of the retaining wire is movably installed in the annular slot. By providing the annular sleeve 58 on the distal end of the delivery sheath 51, the retaining wire can be restricted from moving within the annular slot, ensuring that the retaining wire closes the opening of the through groove 512 and enhancing the retraction performance of the retaining wire.

[0086] It is understandable that in any of the above embodiments, the distance that the wire stop can be pulled and moved must be greater than the radial width of the through slot 512 so that the distal opening of the through slot 512 can be fully opened, thereby not hindering the threading structure of the anchor assembly 34 from sliding out of the through slot 512.

[0087] Furthermore, it is also understood that in order to prevent the retaining wire from breaking when pulled, the diameter of the retaining wire cannot be too small. In some embodiments, the diameter of the retaining wire is 0.2 mm to 0.8 mm. Optionally, in some embodiments, there are two retaining wires. The two retaining wires can disperse the pulling force, making the retaining wire less likely to break and more secure and stable. Of course, in other embodiments, the number of retaining wires can also be one, as long as the length of the retaining wire passing through the annular channel 5741 is sufficient to close the distal openings of the through groove 512 and the narrow slot 572.

[0088] Please also refer to Figures 18 to 20 The anchoring assembly 34 is detachably connected to the distal end of the anchoring device 10. In some embodiments, the anchoring device 10 includes a driving tube 12 and a connecting rod 14 inserted into the driving tube 12. The distal end of the driving tube 12 is provided with a second connecting portion 122 detachably connected to the first connecting portion 3431 of the anchoring seat 343. The connecting rod 14 is axially inserted into the matingly connected first connecting portion 3431 and second connecting portion 122 to maintain the connection between the anchoring assembly 34 and the anchoring device 10. The driving tube 12 is used to drive the anchoring assembly 34 (i.e., the anchor 340) to anchor into the valve annulus.

[0089] The first connecting portion 3431 and the second connecting portion 122 are S-shaped buckles provided at the proximal end of the anchor seat 343 and the distal end of the driving tube 12, respectively. The first connecting portion 3431 and the second connecting portion 122 both have an inner cavity. Figure 20 As shown, when the first connecting portion 3431 and the second connecting portion 122 are docked, the anchor seat 343 and the drive tube 12 are respectively engaged with the S-shaped snap fasteners, and the inner lumens of the two are connected. The distal end of the connecting rod 14, which is installed in the drive tube 12, extends from the distal end of the drive tube 12 and is inserted into the inner lumens of the first connecting portion 3431 and the second connecting portion 122, thereby preventing the first connecting portion 3431 and the second connecting portion 122 from separating, so that the anchor assembly 34 and the drive tube 12 remain connected. By rotating the drive tube 12, the anchor assembly 34 can be driven to rotate, thereby anchoring the anchor portion 341 into the valve annulus. It will be understood that when the distal end of the connecting rod 14 is withdrawn from the docking and fastening of the first connecting portion 3431 and the second connecting portion 122, the first connecting portion 3431 and the second connecting portion 122 can be separated, thereby achieving separation of the anchor assembly 34 from the drive tube 12. The anchor device 10 can be made of a metal material or a polymer material, preferably a metal material with a high hardness, such as stainless steel.

[0090] In other embodiments, the first connecting portion 3431 and the second connecting portion 122 may be a matching structure of a block and a slot. The anchoring device 10 may also be composed of a driving tube 12 and a connecting tube sleeved on the outside of the driving tube 12, with the distal end of the connecting tube sleeved on the outside of the mating first connecting portion 3431 and the second connecting portion 122, which can also function to prevent the first connecting portion 3431 and the second connecting portion 122 from separating.

[0091] See also Figure 21 In some embodiments, the delivery device 50 further includes an elastic filling tube 54, which is used to fill the axially extending gap between the delivery sheath 51 and the anchoring device 10. Specifically, the elastic filling tube 54 is used to fill the axially extending gap between the delivery sheath 51 and the driver tube 12 of the anchoring device 10, thereby preventing excessive deformation of the driver tube 12 during torque and thrust transmission, thereby avoiding travel loss at the proximal end of the driver tube 12. Furthermore, the excellent elastic properties of the elastic filling tube 54 also provide a certain degree of bending and straightening properties at the distal end of the delivery sheath 51. The elastic filling tube 54 may be a spring tube.

[0092] Please refer again Figure 2 and Figure 3 In some embodiments, the implant 30 further includes at least one spacer 36, which is mounted on the tightening wire 32 and is located between two adjacent anchoring assemblies 34. It is understood that the spacer 36 can prevent the tightening wire 32 from being over-tightened, resulting in the distance between two adjacent anchoring assemblies 34 being too short and damaging the valve annulus. At the same time, the spacer 36 can act as a buffer, dispersing the tightening force on the anchoring assemblies 34 and ensuring that the anchoring assemblies 34 are implanted stably. The spacer 36 is a tubular member of a certain length, preferably made of a biocompatible material. The spacer 36 can be wrapped with a coating to reduce the risk of damage to the valve annulus and other heart tissues by the spacer 36.

[0093] Optionally, a spacer 36 may be provided between any two adjacent anchor assemblies 34 of the plurality of anchor assemblies 34 of the implant 30 , or a spacer 36 may be provided between every two or more anchor assemblies 34 , which is not limited thereto.

[0094] See also Figure 22 and Figure 23In some embodiments, the transcatheter shrink ring system 1 further includes a pusher 90 for pushing the spacer 36. Specifically, a guide hole 92 is defined at the distal end of the pusher 90 for allowing the proximal end of the tightening wire 32 to pass therethrough. After the spacer 36 is mounted on the tightening wire 32, the tightening wire 32 passes through the guide hole 92 of the pusher 90. The pusher 90 then pushes the spacer 36 along the tightening wire 32 into the second guide sheath 72 of the guide device 70. The delivery sheath 51 is then mounted in the second guide sheath 72 to push the spacer 36 within the second guide sheath 72.

[0095] It is understood that after the first anchoring assembly 34 is implanted in the annulus, the delivery sheath 51 and the anchoring device 10 are withdrawn, the spacer 36 is threaded onto the proximal end of the tightening wire 32, and the tightening wire 32 is passed through the guide hole 92 of the pushing member 90 along the threading direction a. The pushing member 90 then pushes the spacer 36 along the tightening wire 32 along the pushing direction b into the second guide sheath 72 of the guiding device 70. Then, the pushing member 90 is removed, and the second anchoring assembly 34, which is threaded onto the delivery sheath 51, is threaded onto the tightening wire 32 through its threading ring 347 exposed outside the delivery sheath 51. The delivery sheath 51 is then threaded into the second guide sheath 72, with the spacer 36 located on the distal end of the delivery sheath 51. Thus, the delivery sheath 51 is moved axially distally within the second guide sheath 72, pushing the septum 36 to the annulus. The anchoring device 10 then pushes the second anchor assembly 34 out of the delivery sheath 51 and anchors the second anchor assembly 34 into the annulus, so that the septum 36 is located between the two anchor assemblies 34. The same steps are repeated to sequentially implant multiple anchor assemblies 34 into the annulus, with the septum 36 sequentially inserted between every two or more anchor assemblies 34. The distance between two adjacent anchor assemblies 34 needs to be greater than the axial length of the septum 36.

[0096] Please refer again Figure 1 and Figure 2 In some embodiments, the delivery device 50 further includes a delivery member 53. The distal end of the tightening wire 32 is fixedly connected to the first anchoring assembly 34 for anchoring into the annulus. The distal end of the delivery member 53 is connected to the proximal end of the tightening wire 32, and the proximal end of the delivery member 53 extends outside the body. In this way, the anchoring assembly 34, spacer 36, etc. can be transported and installed on the tightening wire 32 by the delivery member 53, allowing the tightening wire 32 to be selected at an appropriate implant length. This eliminates the need for in vivo trimming of the tightening wire 32, prevents particles from falling off the wire, and makes the ring reduction surgery safer.

[0097] It should be noted that the distal end of the tightening wire 32 is fixedly connected to the first anchoring component 34 for anchoring into the valve annulus, and the other anchoring components 34 for anchoring into the valve annulus are transported along the conveying member 53 and threaded onto the tightening wire 32. Similarly, the spacer 36 is also transported along the conveying member 53 and threaded onto the tightening wire 32. Among them, the tightening wire 32 has a certain axial length and is flexible, and the radial cross-sectional shape of the tightening wire 32 can be circular, oblate, rectangular, square or other shapes; similarly, the conveying member 53 also has a certain axial length and is flexible, and the radial cross-sectional shape of the conveying member 53 can also be circular, oblate, rectangular, square or other shapes; the present application does not make any specific limitation on the radial cross-sectional shape of the tightening wire 32 and the conveying member 53.

[0098] In some embodiments, the proximal end of the tightening wire 32 is folded in a U-shape, and the delivery member 53 passes through the folded portion of the tightening wire 32 to achieve a detachable connection. In other embodiments, the delivery member 53 can also be detachably connected to the tightening wire 32 through a threaded connection, a snap-fit connection, or other methods, which will not be described in detail. Of course, the delivery member 53 can also be non-detachably connected to the tightening wire 32, and can be removed from the body by cutting the delivery member 53 outside the body.

[0099] See also Figures 1 to 3 In some embodiments, the catheter reduction ring system 1 further includes an adjustment device 80, and the implant 30 further includes a wire retractor 38. The adjustment device 80 is used to transport and control the wire retractor 38. The wire retractor 38 is transported along the transport member 53 and threaded onto the tightening wire 32. The wire retractor 38 is used to adjust the tightening wire 32 to adjust the spacing between the multiple anchor assemblies 34, and to lock the tightening wire 32 after the spacing between the multiple anchor assemblies 34 is adjusted. Typically, the wire retractor 38 is used to tighten the tightening wire 32 to reduce the spacing between the multiple anchor assemblies 34.

[0100] Specifically, after multiple anchoring assemblies 34 and spacers 36 are implanted in the annulus, the take-up device 38 is threaded onto the tightening wire 32 along the conveyor member 53. The take-up device 38 is then used to tighten and lock the tightening wire 32, maintaining a predetermined length on the annulus. The conveyor member 53 is then withdrawn, releasing the tightening wire 32, completing the annulus contraction and alleviating blood reflux. It will be appreciated that by enabling the take-up device 38 to be threaded onto the tightening wire 32 and released smoothly via the conveyor member 53, there is no need to implant the take-up device 38 in the patient's body in advance, simplifying the surgical procedure, reducing surgical difficulty, and shortening the surgical time.

[0101] It should be noted that the distal end of the conveying member 53 is connected to the proximal end of the tightening wire 32, and the proximal end of the conveying member 53 extends outside the patient's body. The anchoring assembly 34, the spacer 36 and the wire reel 38 can be conveyed through the conveying member 53 extending outside the body to be installed on the tightening wire 32, so that the tightening wire 32 can choose a suitable implantation length, and the length of the tightening wire 32 on the valve ring can be adjusted and locked by the wire reel 38, without the need to cut the tightening wire 32.

[0102] Please also refer to Figures 24 to 27 In some embodiments, the wire take-up device 38 includes a housing 381 and a winding shaft 383 rotatably disposed within the housing 381. The wire take-up device 38 moves toward the distal end of the conveying member 53 to allow the proximal end of the take-up wire 32 to flexibly pass through the housing 381 and the winding shaft 383. The winding shaft 383 rotates relative to the housing 381 to wind the take-up wire 32. When the winding shaft 383 stops rotating, the take-up wire 32 is locked in the radial space between the winding shaft 383 and the housing 381.

[0103] It is understandable that by controlling the winding shaft 383 to rotate relative to the housing 381, the tightening wire 32 can be wound, so that the tightening wire 32 is continuously tightened to shrink the valve ring until the blood reflux weakens or disappears, and the rotation of the winding shaft 383 can be stopped. At this time, the tightening wire 32 is locked in the radial space between the winding shaft 383 and the housing 381, and the tightening wire 32 maintains a certain length on the valve ring. The tightening wire 32 is wound and locked by the take-up device 38, and the locking effect of the tightening wire 32 is good. Furthermore, if after a period of time, the patient's valve ring expands again and causes recurrence of reflux, the take-up device 38 can be directly controlled to further wind the tightening wire 32 to shrink the valve ring so that the reflux weakens or disappears, thereby avoiding a second operation that causes greater harm to the patient. The take-up device 38 can be made of a biocompatible material, such as stainless steel, without limitation.

[0104] It should be noted that the tightening wire 32 is wound at least three times on the winding shaft 38. The friction between each turn of the tightening wire 32 can offset the tension generated by the movement of the leaflet, ensuring that the tightening wire 32 is not pulled and maintains a certain length on the valve ring.

[0105] Specifically, the housing 381 includes a bottom housing 3812 and an outer housing 3814. The outer housing 3814 has openings at both its proximal and distal ends. The bottom housing 3812 is fixedly connected to the distal end of the outer housing 3814 to form an installation space 3816. The cable take-up device 38 also includes a stop post 385, a stop wheel 387, and an elastic member 389. The stop post 385, elastic member 389, stop wheel 387, and the winding shaft 383 are disposed within the installation space 3816 of the housing 381.

[0106] like Figure 25 and Figure 26As shown, the winding shaft 383 has a through hole 3832 along its radial direction. The housing 3814 has two wire holes 3818 on either side of the winding shaft 383. Both wire holes 3818 communicate with the through hole 3832 of the winding shaft 383. When the wire take-up 38 is installed on the conveyor 53, the conveyor 53 first passes through one wire hole 3816 into the installation space 3816 of the housing 381, then passes through the through hole 3832 of the winding shaft 383, and finally exits the housing 381 through the other wire hole 3818. Preferably, the central axes of the two wire holes 3818 and the central axis of the through hole 3832 are coplanar. The winding shaft 383 can be rotated to align the central axis of the through hole 3832 with the central axes of the two wire holes 3818. This facilitates smooth passage of the conveyor 53 through the two wire holes 3818 and the through hole 3832, thereby allowing the wire take-up 38 to be delivered to the take-up wire 32.

[0107] like Figure 26 and Figure 27 As shown, the distal end of the limiting column 385 is fixedly connected to the bottom shell 3812. The anti-rotation wheel 387 is sleeved on the limiting column 387 and can move axially along the limiting column 385. The proximal end surface of the anti-rotation wheel 387 is circumferentially provided with a plurality of first bevel teeth 3871, and the distal end surface of the winding shaft 383 is circumferentially provided with a plurality of second bevel teeth 3831. The winding shaft 383 is sleeved on the limiting column 385 so that the second bevel teeth 3831 can cooperate with the first bevel teeth 3871 for unidirectional rotation. The elastic member 389 is located between the anti-rotation wheel 387 and the bottom shell 3812, one end of which abuts against the bottom shell 3812, and the other end abuts against the anti-rotation wheel 387. The elastic member 389 is used to provide elastic force to the anti-rotation wheel 387 so that the first bevel teeth 3871 of the anti-rotation wheel 387 fit the second bevel teeth 3831 of the winding shaft 383. When the winding shaft 383 rotates forward relative to the housing 381 and the stop wheel 387, the second beveled teeth 3871 slip on the first beveled teeth 3831, causing the stop wheel 387 to move distally. After the winding shaft 383 rotates relative to the stop wheel 387 by one beveled tooth angle, the stop wheel 387, under the elastic force applied by the elastic member 389, moves proximally, causing the first beveled teeth 3831 and the second beveled teeth 3871 to re-engage, allowing the winding shaft 383 to continue rotating relative to the housing 381 and the stop wheel 387. When the winding shaft 383 is rotated in the reverse direction, the second beveled teeth 3871 cannot move the stop wheel 387 distally, and the second beveled teeth 3871 cannot pass over any of the first beveled teeth 3831, preventing the winding shaft 383 from reversing. Therefore, when the winding shaft 383 stops rotating, the take-up wire 32 is locked in the radial space between the winding shaft 383 and the housing 381. The elastic member 389 may be, but is not limited to, a spring, a tubular spring sheet, an elastic bellows, and the like.

[0108] See also Figures 25 to 27The distal end of the winding shaft 383 is further provided with a groove (not shown) that cooperates with the proximal end of the limiting post 385. The proximal end of the limiting post 385 is received in the groove at the distal end of the winding shaft 383, and the proximal end of the limiting post 385 contacts the distal end of the winding shaft 383, thereby jointly limiting the axial displacement of the winding shaft 383 in the installation space 3816 with the proximal end of the housing 3814, so that the winding shaft 383 can only rotate. The proximal end of the anti-rotation wheel 387 is further provided with a limiting boss 3873, and the distal end of the housing 3814 is correspondingly provided with a limiting groove 3813. The limiting boss 3873 is clamped in the corresponding limiting groove 3813, which can limit the rotation of the anti-rotation wheel 387, so that the anti-rotation wheel 387 can only move along the axial direction of the limiting post 385.

[0109] In other embodiments, after multiple anchoring components 34 and spacers 36 are implanted in the valve ring, the tightening wire 32 is pulled to shrink the ring so that blood reflux is weakened or eliminated, and then a locking nail can be transported along the conveying member 53 to lock the tightened tightening wire 32, so that the tightening wire 32 remains in the tightened state, and the conveying member 53 can be withdrawn.

[0110] Please also refer to Figure 1 、 Figure 24 and Figure 27 In some embodiments, the adjustment device 80 includes a threaded rod 82, a rotating tube 84, and an outer sheath 86, arranged from the inside out. The outer sheath 86 engages with the cable take-up device housing 381 to restrict rotation of the housing 381. The rotating tube 84 engages with the proximal end of the winding shaft 383. The threaded rod 82 is threadedly connected to the winding shaft 383, pressing against the rotating tube 84 to maintain the connection between the rotating tube 84 and the winding shaft 383. Therefore, rotating the rotating tube 84 drives the winding shaft 383 to rotate, thereby winding and tightening the take-up wire 32.

[0111] In some embodiments, the shell of the housing 381 is provided with a slot 3811, and the distal end of the outer sheath 86 is provided with a claw 862 corresponding to the slot 3811. Through the cooperation of the claw 862 and the slot 3811, the outer sheath 86 is connected to the housing 381. The proximal end of the winding shaft 383 extends from the proximal end opening of the housing 3814, and the proximal end of the winding shaft 383 is provided with a threaded hole along its axial direction. The inner wall of the rotating tube 84 is convexly provided with a first boss 842, and the outer wall of the threaded rod 82 is convexly provided with a second boss 822. After the rotating tube 84 is engaged with the winding shaft 383, the threaded rod 82 is screwed into the threaded hole, that is, the threaded rod 82 is screwed into the winding shaft 383, so that the first boss 842 is pressed between the winding shaft 383 and the second boss 822, and the rotating tube 84 remains connected to the winding shaft 383. At this time, the outer sheath 86 limits the rotation of the shell 381, and rotating the rotating tube 84 can drive the threaded rod 82 and the winding shaft 383 to rotate synchronously, so that the winding shaft 383 rotates relative to the shell 381 to wind the tightening wire 32 and tighten the tightening wire 32 to achieve ring shrinkage.

[0112] It is understandable that in other embodiments, the conveying member 53 can be omitted, and the length of the tightening line 32 is long enough to extend outside the patient's body. After multiple anchoring components 34 are implanted, the tightening line 32 is tightened to achieve a shrinking ring. After achieving the best effect of reducing reflux, the tightening line 32 can be locked and cut using locking nails in existing technology.

[0113] It should be noted that the anchoring device 10, the conveying device 50, the guiding device 70 and the adjusting device 80 included in the transcatheter ring shrinking system 1 also have corresponding control handles, and their structures are basically similar to the handle structures in the prior art, which will not be described in detail.

[0114] The following will be combined Figure 2 、 Figure 3 and Figures 28 to 32 The application of the transcatheter ring shrinking system 1 in mitral annuloplasty is used as an example to illustrate the use process and working principle of the transcatheter ring shrinking system 1 according to the embodiment of the present application. The surgical route is: via the femoral vein - inferior vena cava - right atrium (RA) - atrial septum (AS) - left atrium (LA) - mitral valve (MV) annulus.

[0115] The first step is to puncture the femoral vein and establish a track of femoral vein-inferior vena cava-right atrium-atrial septum-left atrium-mitral valve ring through a guide wire (the guide wire and atrial septal puncture device are not shown in the figure).

[0116] The second step is Figure 28 As shown, the guide device 70 is advanced along the guide wire until its distal end passes through the foramen ovale to reach the left atrium and is advanced to the vicinity of the valve ring, and then the guide wire is withdrawn.

[0117] The third step, such as Figure 29 As shown, the threading ring 347 of the first anchoring assembly 34 is fixedly connected to the distal end of the tightening wire 32, and the proximal end of the tightening wire 32 is detachably connected to the distal end of the delivery member 53. First, the first anchoring assembly 34 is assembled to the distal end of the delivery sheath 51 and detachably connected to the anchoring device 10, wherein the threading ring 347 of the first anchoring assembly 34 is exposed as a whole from the through groove 512, and the tightening wire 32 and the delivery member 53 are located outside the delivery sheath 51; then, the delivery sheath 51 is moved axially distally in the guide device 70 until its distal end abuts the predetermined treatment site of the valve ring. In the process of assembling the anchoring assembly 34 to the distal end of the delivery sheath 51, it is necessary to pull the stop wire (i.e., the stopper 55) toward the proximal end to open the distal opening of the through groove 512, so that the threading structure of the anchoring assembly 34 enters the through groove 512 and then releases the stop wire, and the stop wire is reset to close the distal opening of the through groove 512.

[0118] The fourth step is as follows Figure 30As shown, the retaining wire is pulled to move toward the proximal end to open the distal opening of the through slot 512, and then the first anchoring assembly 34 is implanted on the annulus of the mitral valve using the anchoring device 10 installed in the inner cavity of the delivery sheath 51. Figure 31 As shown, the delivery sheath 51 is withdrawn toward the proximal end, so that the first anchoring assembly 34 is completely separated from the delivery sheath 51, and the connection between the anchoring device 10 and the first anchoring assembly 34 is released.

[0119] Step 5: After implanting the first anchoring assembly 34, withdraw the anchoring device 10 and the delivery sheath 51, and introduce the spacer 36 into the guide device 70 through the delivery member 53; then pass the proximal end of the delivery member 53 through the threading ring 347 of the second anchoring assembly 34 (the second anchoring assembly 34 has been connected to the distal end of the anchoring device 10 and installed on the delivery sheath 51) and push the delivery sheath 51 into the guide device 70. By pushing the delivery sheath 51 forward, the first spacer 36 and the second anchoring assembly 34 are transported along the delivery member 53 to be installed on the tightening wire 32 and transported to the vicinity of the valve annulus, with the spacer 36 between the first anchoring assembly 34 and the second anchoring assembly 34. Figure 32 As shown, under ultrasound and digital subtraction angiography (DSA), the position of the second anchoring assembly 34 is adjusted according to the size of the diseased valve annulus by controlling the guide device 70 and the delivery sheath 51, and the second anchoring assembly 34 is implanted. The distance between the second anchoring assembly 34 and the first anchoring assembly 34 needs to be greater than the axial length of the spacer 36.

[0120] Step 6: Repeat step 5, and sequentially implant the anchoring assembly 34 and the spacer 36 from the anterior triangular region of the mitral valve along the posterior annulus to the posterior triangular region or vice versa, so that the anchoring assembly 34 and the spacer 36 are evenly distributed on the annulus (e.g., Figure 2 As shown), after a sufficient number of anchoring components 34 are implanted, the anchoring device 10 and the delivery sheath 51 are withdrawn.

[0121] In the seventh step, first connect the take-up wire 38 to the distal end of the adjustment device 80, and pass the proximal end of the conveying member 53 through the take-up wire 38, and send the take-up wire 38 along the conveying member 53 to the tightening wire 32; then, rotate the rotating tube 84 of the adjustment device 80 forward so that the winding shaft 383 of the take-up wire 38 adjusts the length of the tightening wire 32 on the valve ring to reduce the spacing between the multiple anchoring components 34, thereby driving the valve ring to shrink. After achieving a good shrinking effect, the rotating tube 84 stops rotating, the take-up wire 38 locks the tightening wire 32, and then reverses the threaded rod 82 to disengage the take-up wire 38 from the adjustment device 80 to facilitate the withdrawal of the adjustment device 80, leaving the implant 30 on the valve ring (such as Figure 3 The ring reduction surgery is completed.

[0122] It should be noted that during the implantation of the anchoring assembly 34, there is a low probability of wire compression. At this time, the DSA and ultrasonic equipment can be combined to reversely rotate the driving tube 12 of the anchoring device 10, loosen the anchoring assembly 34, and make the tightening line 32 fall out. Then, the anchoring assembly 34 can be tightened again for implantation.

[0123] It is understandable that the transcatheter ring shrinkage system 1 provided in the present application can also be used for tricuspid annuloplasty, which will not be described in detail. In addition, it should be noted that the transcatheter ring shrinkage system 1 provided in the present application can also be used to implant multiple anchoring assemblies 34 connected in series by tightening wires 32 in cardiac tissues such as the left ventricular wall or the right ventricular wall. By tightening the tightening wires 32, the spacing between the multiple anchoring assemblies 34 is reduced, so as to achieve the purpose of reducing the valve ring by narrowing the ventricle and reducing the ventricular volume, thereby achieving the treatment of mitral valve regurgitation or tricuspid valve regurgitation. In addition to being directly implanted on the valve ring on the atrial side as shown in the embodiment, the implant 30 can also be implanted under the valve ring, that is, the implant 30 can also be implanted in the left ventricular wall under the mitral valve ring or the right ventricular wall under the tricuspid valve ring. Among them, the implant 30 implanted on the left ventricular wall is particularly suitable for treating heart failure caused by abnormal left ventricular function and functional mitral valve regurgitation. The guide device 70 can be inserted through the femoral artery, retrogradely passed through the aortic valve and into the left ventricle. The implant 30 is then implanted into the left ventricle wall via the delivery device 50 and the anchoring device 10. After tightening, the tightening wire 32 directly inhibits left ventricular dilation, thereby reducing the size of the mitral valve annulus. This subannular annular shaping can preserve the natural structure of the mitral valve. In other words, the transcatheter ring reduction system 1 of the present application can be used not only to shrink the annulus during annuloplasty, but also to reduce ventricular volume during ventricular volume reduction surgery. The specific use process is basically similar to that of the aforementioned mitral annuloplasty and will not be described in detail here.

[0124] In summary, the transcatheter shrink ring system 1 of the present application can be used to anchor multiple anchoring components 34 connected by tightening lines 32 on heart tissues such as the mitral valve annulus, tricuspid valve annulus, left ventricular wall, and right ventricular wall, and the spacing between the multiple anchoring components 34 can be reduced by tightening the tightening lines 32, thereby achieving the treatment of heart failure caused by mitral valve regurgitation, tricuspid valve regurgitation or left ventricular dysfunction.

[0125] Throughout this specification, reference to terms such as "some embodiments," "illustrative embodiments," "examples," "specific examples," or "some examples" means that the specific features, structures, materials, or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the present application. In this specification, the schematic representations of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

[0126] Although the embodiments of the present application have been shown and described, those skilled in the art will appreciate that various changes, modifications, substitutions, and variations may be made to the embodiments without departing from the principles and intent of the present application, and that the scope of the present application is defined by the claims and their equivalents.

Claims

1. A conveying device for preventing winding, used for conveying anchor components and tightening wires, characterized in that: The delivery device includes a delivery sheath and a stopper, wherein a through groove extending from the distal end to the proximal end is formed in the wall of the delivery sheath, the through groove being connected to the inner cavity of the delivery sheath, and the distal end of the through groove having an opening, the anchor assembly being movably mounted on the delivery sheath and connected to the tightening wire, the stopper being provided at the distal end of the delivery sheath, and the stopper being used to close the opening to separate the distal end of the anchor assembly from the tightening wire; Wherein, the stop portion is a slender member movably provided at the distal end of the delivery sheath, or a blocking piece fixedly provided at the distal end of the delivery sheath.

2. The anti-winding conveying device according to claim 1, characterized in that: The stopper is an elongated member movably provided at the distal end of the delivery sheath, and the stopper opens the opening to movably pass the anchor assembly through the delivery sheath. When the anchor assembly is delivered, the stopper closes the opening.

3. The anti-winding conveying device according to claim 2, characterized in that: The proximal end of the stop portion extends along the axial direction of the delivery sheath tube, and the distal end of the stop portion adapts to the circumference of the delivery sheath tube. At least the distal end portion of the stop portion is made of a material with shape memory function.

4. The anti-winding conveying device according to claim 3, characterized in that: The distal end of the stopper closes the opening when no external force is applied.

5. The anti-winding conveying device according to claim 3, characterized in that: The stopper is pulled toward the proximal end to open the opening; when the pulling force on the stopper is released, the distal end of the stopper returns to its original position under the effect of its own memory function to close the opening.

6. The anti-winding conveying device according to claim 3, characterized in that: The distal end of the stopper is a non-closed loop in a natural state.

7. The anti-winding conveying device according to claim 3, characterized in that: The distal end of the stopper portion comprises an arc-shaped segment in a natural state.

8. The anti-winding conveying device according to claim 3, characterized in that: The delivery device also includes a sleeve fixedly nested in the distal inner cavity of the delivery sheath, the sleeve includes a tube body and an annular portion arranged at the distal end of the tube body, the annular portion has an annular channel, the proximal end of the stop portion movably extends axially in the tube wall or inner cavity of the delivery sheath, and the distal end of the stop portion movably passes through the annular channel.

9. The anti-winding conveying device according to claim 8, characterized in that: A narrow slot is formed on the tube body corresponding to the through slot, and a radial width of the narrow slot is greater than or equal to a radial width of the through slot.

10. The anti-winding conveying device according to claim 9, characterized in that: The annular portion has a notch corresponding to the slot, and a size of the notch is consistent with a radial width of the slot.

11. The anti-winding conveying device according to claim 10, characterized in that: The size of the notch is less than 1 / 3 of the length of the annular channel.

12. The anti-winding conveying device according to claim 8, characterized in that: The tube wall or inner cavity of the delivery sheath is axially provided with a stop channel, and the tube body is provided with a wire threading groove connecting the stop channel and the annular channel. The proximal end of the stop part moves through the wire threading groove and extends axially along the stop channel.

13. The anti-winding conveying device according to claim 12, characterized in that: The distal end of the wire threading groove is arc-shaped and communicates with the annular channel, and the proximal end of the wire threading groove is communicated with the stop channel.

14. The anti-winding conveying device according to claim 12, characterized in that: The sleeve further comprises a cover plate fixedly connected to the tube body, and the cover plate is used to limit the movement of the stop portion in the wire threading groove.

15. The anti-winding conveying device according to claim 8, characterized in that: The annular portion includes an annular seat body provided at the distal end of the tube body and an annular seat cover cooperatively connected with the annular seat body, and the annular channel is formed between the annular seat body and the annular seat cover.

16. The anti-winding conveying device according to claim 3, characterized in that: A stop channel is provided in the tube wall or inner cavity of the delivery sheath tube along the axial direction, and the distal end of the stop channel passes through the tube wall of the delivery sheath tube and is located on one side of the through groove in the radial direction; The stop portion is movably installed in the stop channel, and the distal end of the stop portion extends from the distal end of the stop channel.

17. The anti-winding conveying device according to claim 16, characterized in that: The distal outer wall of the delivery sheath is provided with an annular shell, and the annular shell has a notch corresponding to the through groove. An annular slot is formed between the distal outer wall of the delivery sheath and the annular shell, the distal end of the stop channel is connected to the annular slot, and the distal end of the stop part is movably installed in the annular slot.

18. The anti-winding conveying device according to any one of claims 1 to 17, characterized in that: The anchor assembly includes an anchor and a threading structure provided on the anchor, and the tightening line is connected to the threading structure; When the anchor assembly is installed on the delivery sheath, the portion of the tightening wire extending distally from the connection point with the anchor assembly is located outside the delivery sheath.

19. The anti-winding conveying device according to claim 18, characterized in that: The threading structure is entirely located in the inner cavity of the delivery sheath, and the tightening wire passes through the through slot into the inner cavity of the delivery sheath and is connected to the threading structure.

20. The anti-winding conveying device according to claim 18, wherein: At least a portion of the threading structure is exposed from the through slot and is located outside the delivery sheath, and the tightening wire is connected to the portion of the threading structure located outside the delivery sheath.

21. The anti-winding conveying device as described in claim 18, wherein the anchoring member includes an anchoring portion and an anchoring seat connected to the proximal end of the anchoring portion, the threading structure includes a connecting member movably mounted on the anchoring seat and a threading ring movably connected to the connecting member, and the tightening line is connected to the threading ring.

22. The anti-winding conveying device according to claim 21, characterized in that: The radial width of the through slot is greater than the axial thickness of the threading ring. The threading ring is at least partially exposed from the through slot and located outside the delivery sheath. The tightening wire is connected to the portion of the threading ring located outside the delivery sheath.

23. The anti-winding conveying device according to claim 22, characterized in that: The radial width of the through slot is smaller than the maximum outer diameter of the threading ring, and the axial length of the through slot is larger than the maximum outer diameter of the threading ring.

24. The anti-winding conveying device according to claim 23, characterized in that: The axial length of the through groove is greater than the axial distance between the proximal end of the connecting member and the distal end of the anchoring portion.

25. The anti-winding conveying device according to claim 22, characterized in that: The connecting piece is provided with an assembly hole and a connection hole. The anchor seat is installed in the assembly hole. The threading ring passes through the connection hole and is connected to the connecting piece.

26. The anti-winding conveying device according to claim 25, characterized in that: The connecting hole extends in an axial direction of the anchor or in a radial direction of the anchor.

27. The anti-winding conveying device according to claim 25, characterized in that: A clamping end is protruded from one side of the connecting member away from the anchor seat. The radial width of the clamping end is adapted to the radial width of the through slot, and the clamping end is clamped in the through slot.

28. The anti-winding conveying device according to claim 27, characterized in that: The connecting hole is opened at the holding end, and the connecting hole extends along the radial direction of the anchoring member. The holding end is provided with a guiding inclined surface protruding toward the proximal end along the axial direction of the anchoring member.

29. A transcatheter ring shrinkage system, characterized in that: A device comprising an implant, an anchoring device, and the anti-winding delivery device according to any one of claims 1 to 28, wherein the implant comprises the tightening wire and a plurality of the anchoring assemblies; The anchoring assembly is detachably connected to the distal end of the anchoring device and is inserted into the delivery sheath. The delivery sheath is used to deliver the anchoring assembly and the tightening wire to the heart tissue. The anchoring device is used to drive the anchoring assembly to anchor into the heart tissue. The distal end of the tightening wire is fixedly connected to the first anchoring component for anchoring into the heart tissue, and the proximal end of the tightening wire can slide through the other anchoring components for anchoring into the heart tissue.

30. The transcatheter shrink ring system according to claim 29, wherein: The implant further includes at least one spacer, which is threaded onto the tightening wire and located between the two anchor components.

31. The transcatheter shrink ring system according to claim 29, wherein: The conveying device further comprises a conveying member, the distal end of which is connected to the proximal end of the tightening line.

32. The transcatheter shrink ring system according to claim 31, wherein: The implant also includes a wire take-up device, which includes a shell and a winding shaft rotatably arranged in the shell. The wire take-up device moves toward the distal end of the conveying member so that the proximal end of the tightening wire can movably pass through the shell and the winding shaft. The winding shaft rotates relative to the shell to wind the tightening wire. When the winding shaft stops rotating, the tightening wire is locked in the radial space between the winding shaft and the shell.

33. The transcatheter shrink ring system according to claim 29, wherein: The transcatheter shrink ring system further includes an elastic filling tube, which is used to fill the gap extending along the axial direction between the delivery sheath and the anchoring device.

34. The transcatheter shrink ring system according to claim 29, wherein: The heart tissue includes the mitral valve annulus, the tricuspid valve annulus, the left ventricular wall, and the right ventricular wall.

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