Patent Publication Number: US-2023142064-A1

Title: Systems and methods for heart valve leaflet repair

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
     The present application is a Continuation of International Patent Application PCT/US2021/039587 to Chau et al., filed Jun. 29, 2021, which published as WO 2022/006087, and which claims priority to: 
     U.S. Provisional Patent Application 63/046,638 to Chau et al., filed Jun. 30, 2020; and 
     U.S. Provisional Patent Application 63/124,704 to Chau et al., filed Dec. 11, 2020. 
     Each of the above-referenced applications is incorporated herein by reference in their entirety for all purposes. 
    
    
     BACKGROUND 
     The native heart valves (i.e., the aortic, pulmonary, tricuspid, and mitral valves) serve critical functions in assuring the forward flow of an adequate supply of blood through the cardiovascular system. These heart valves can be rendered less effective by congenital malformations, inflammatory processes, infectious conditions, or disease. Such damage to the valves can result in serious cardiovascular compromise or death. Treatment for such disorders can be done with the surgical repair or replacement of the valve during open heart surgery or with transcatheter transvascular techniques for introducing and implanting prosthetic devices in a manner that is much less invasive than open heart surgery. 
     A healthy heart has a generally conical shape that tapers to a lower apex. The heart has four chambers: the left atrium, right atrium, left ventricle, and right ventricle. The left and right sides of the heart are separated by a wall generally referred to as the septum. The native mitral valve of the human heart connects the left atrium to the left ventricle. The mitral valve includes an annulus portion, which is an annular portion of the native valve tissue surrounding the mitral valve orifice, and a pair leaflets (as referred to as cusps) that extend downward from the annulus into the left ventricle. The mitral valve annulus can form a “D” shaped, oval, or otherwise out-of-round cross-sectional shape having major and minor axes. The anterior leaflet can be larger than the posterior leaflet, forming a generally “C” shaped boundary between the abutting free edges of the leaflets when they are closed together. 
     When operating properly, the anterior leaflet and the posterior leaflet function together as a one-way valve to allow blood to flow only from the left atrium to the left ventricle. The left atrium receives oxygenated blood from the pulmonary veins. When the muscles of the left atrium contract and the left ventricle dilates, the oxygenated blood that is collected in the left atrium flows into the left ventricle. When the muscles of the left atrium relax and the muscles of the left ventricle contract, the increased blood pressure in the left ventricle urges the two leaflets together, thereby closing the one-way mitral valve so that blood cannot flow back to the left atrium and is instead expelled out of the left ventricle through the aortic valve. To prevent the two leaflets from prolapsing or flailing under pressure and folding back through the mitral annulus toward the left atrium, a plurality of fibrous cords called chordae tendineae tether the leaflets to papillary muscles in the left ventricle. 
     Valve regurgitation occurs when the native valve fails to close properly and blood flows into the left atrium from the left ventricle during the systole phase of heart contraction. Valve regurgitation (especially mitral valve regurgitation) is the most common form of valvular heart disease. Mitral regurgitation has different causes, including leaflet prolapse or flail, restricted leaflet motion (e.g., due to leaflet rigidity/leaflet calcification), and/or dysfunctional papillary muscles stretching. 
     Some techniques for treating leaflet valve regurgitation due to flail and prolapse include stitching or otherwise coupling portions of the native valve leaflets directly to one another, but there is a continuing need for improved devices and methods for treating leaflet flail, prolapse, and restricted leaflet motion. 
     SUMMARY OF THE INVENTION 
     Many examples herein are directed to towards systems, apparatuses, devices, methods, etc. that can mitigate leaflet flail, prolapse, abnormal leaflet motion, and/or other problems. For example, various embodiments of systems, devices, etc. provide contact pressure on the flailed, prolapsed, or restricted region of the leaflet. Some embodiments of systems, devices, etc. herein are anchored within nearby vasculature. Some embodiments of systems, devices, etc. herein are anchored directly to the annulus and/or a leaflet. Some embodiments of systems, devices, etc. are compressed onto the leaflet to be repaired. 
     In some applications, a system (e.g., a leaflet repair system, an arrestor system, a prolapse repair system, a flail repair system, a repair system, etc.) is for use within a heart valve. The system can include a device (e.g., a repair device, a leaflet repair device, an arrestor, etc.) comprising a contact face contoured to and capable of providing contact pressure onto an influent face of a heart valve leaflet (e.g., onto an atrial side of an atrioventricular valve). The system includes an anchor capable of anchoring within vasculature. And the system includes a connector or an anchor receiver that connects the device and the anchor. 
     In some applications, the device is an implant that comprises a flexible wing and an interface, and the system comprises a delivery tool that is engageable with the interface, and that can be used to position and anchor the interface to tissue of the heart (e.g., to an annulus of the valve being treated) such that the wing extends over a first leaflet of the valve (e.g., over a prolapsing or flailing portion of the leaflet), toward an opposing leaflet of the valve. For some such applications, the wing is curved, and the positioning and anchoring is such that the wing curves downstream between the leaflets, e.g., such that a tip (e.g., a free end) of the wing is disposed within the ventricle downstream of the valve being treated. 
     In some applications, the contact face of the device has a length and a width to cover a prolapse or a flail of the heart valve leaflet. 
     In some applications, the contact face of the device is capable of providing contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the system further includes a coaptation portion that is extended from the contact face, the coaptation portion is capable extending the length of the device into coaptation area of the valve. 
     In some applications, the coaptation portion is capable of helping promote coaptation between the leaflets of the valve. 
     In some applications, the device is a wire form. 
     In some applications, the wire form is nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), polyethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), or fluorinated ethylene propylene (FEP). 
     In some applications, the wire form is compactible to fit within a delivery catheter. 
     In some applications, the wire form is self-expanding. 
     In some applications, the system further includes a sheet that is attached upon the wire form, the sheet forming the contact face. 
     In some applications, the sheet has a length and a width to cover a prolapse or a flail of the heart valve leaflet. 
     In some applications, the sheet is capable of providing contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the sheet is permeable, semipermeable, or impermeable. 
     In some applications, the sheet is a mesh. 
     In some applications, the sheet is poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), or polycaprolactone (PCL). 
     In some applications, the system further includes a latch or a hook capable of latching or hooking within a heart valve leaflet commissure or cleft. 
     In some applications, the system includes a static portion and a dynamic portion. The dynamic portion is capable of being repositioned or resized. 
     In some applications, the anchor is a wire stent. 
     In some applications, the anchor is a pin fastener. 
     In some applications, the anchor is a wire fastener that clasps a wire. 
     In some applications, the connector or anchor receiver comprises one or more of a rivet, suture, staple, wire, pin, shaft, sheet, mesh, housing, tubular member, cross-bar, etc. 
     In some applications, the system further includes a clamp that is capable of clamping the device (e.g., repair device, leaflet repair device, arrestor, etc.) to the leaflet. 
     In some applications, a tether extends from the device and is capable of extending to a pinning location on the effluent side of the valve (e.g., on the ventricular side of an atrioventricular valve). 
     In some applications, the device incorporates an internal gap in coaptation area of the device. The internal gap is free of wire form. 
     In some applications, the device incorporates a coaptation element, spacer, gap filler, etc. 
     In some applications, the coaptation element/spacer/filler comprises foam, hydrogel, or silicone. 
     In some applications, the coaptation element/spacer/filler comprises a scissor mechanism or a coil. 
     In some applications, the device incorporates an expandable stent. 
     In some applications, the device is configured to be implanted within a mitral valve, a tricuspid valve, an aortic valve, or a pulmonic valve. 
     In some applications, the anchor is configured to be implanted within vasculature nearby the valve, and wherein the connector traverses a chamber wall. 
     In some applications, the device is configured to be implanted within the mitral valve, the anchor is configured to be implanted within the coronary sinus, and the connector traverses the left atrium wall. 
     In some applications, the system further includes a delivery catheter. The device, the connector, and the anchor are each compactable within the delivery catheter. 
     In some applications, the delivery catheter is configured to be delivered via a transfemoral, subclavian, transapical, transseptal, or transaortic approach. 
     The methods herein, e.g., delivery of the systems/devices herein, can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
     In some applications, a compressive device is for use within a heart valve. The compressive device includes an influent portion, an effluent portion, and a coaptation portion. The influent portion is capable of situating upon the influent face of a heart valve leaflet. The effluent portion is capable of situating upon the effluent face of a heart leaflet. In some applications, the coaptation portion connect the influent portion and the effluent portion. The influent portion and the effluent portion are capable of compressing together such that the stent can stabilize upon a heart valve leaflet when implanted. The stent is contoured to the shape of heart valve leaflet. 
     In some applications, the influent portion is capable of providing contact pressure onto a heart valve leaflet prolapse or flail. 
     In some applications, the compressive device is a wire form. 
     In some applications, the wire form is nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), polyethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), or fluorinated ethylene propylene (FEP). 
     In some applications, the wire form is compactible to fit within a delivery catheter. 
     In some applications, the wire form is self-expanding. 
     In some applications, the compressive device further includes a sheet that is attached upon the influent portion of wire form. 
     In some applications, the sheet has a length and a width to cover a prolapse or a flail of the heart valve leaflet. 
     In some applications, the sheet is capable of providing contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the sheet is permeable, semipermeable, or impermeable. 
     In some applications, the sheet is a mesh. 
     In some applications, the sheet is poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), or polycaprolactone (PCL). 
     In some applications, the compressive device further includes an extended coaptation portion that is capable of extending beyond a leaflet edge. The extended coaptation portion incorporates an impermeable sheet. 
     In some applications, the extended coaptation portion incorporates a thickened material. The impermeable sheet covers the thickened material, and the thickened material is capable of filling a gap within the aperture of a heart valve when it is closed. 
     In some applications, the extended coaptation portion includes a bent angle. 
     In some applications, the compressive device further includes an anchor capable of anchoring within vasculature and a connector or an anchor receiver that connect the compressive device and the anchor. 
     In some applications, the anchor is a wire stent. 
     In some applications, the anchor is a pin fastener. 
     In some applications, the anchor is a wire fastener that clasps a wire. 
     In some applications, the connector or anchor receiver comprises one or more of a rivet, suture, staple, wire, pin, shaft, sheet, mesh, housing, tubular member, cross-bar, etc. 
     In some applications, the compressive device is configured to be implanted within a mitral valve, a tricuspid valve, an aortic valve, or a pulmonic valve. 
     In some applications, the anchor is configured to be implanted within vasculature nearby the valve, and wherein the connector is traverse to a chamber wall. 
     In some applications, the compressive device is configured to be implanted within the mitral valve, the anchor is configured to be implanted within the coronary sinus, and the connector is traverse the left atrium wall. 
     In some applications, the compressive device further comprises a delivery catheter and the compressive device is compacted within the delivery catheter. 
     In some applications, the delivery catheter is configured to be delivered via a transfemoral, subclavian, transapical, transseptal, or transaortic approach. 
     The methods herein, e.g., delivery of the systems/devices herein, can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
     In some applications, a bar device is for use within a heart mitral valve. The bar device includes an arched bar. The bar device includes a hook or latch on each of the two distal ends of the arched bar that are capable of hooking or latching into the commissures of a mitral valve. The bar device includes an anchor capable of anchoring within vasculature. And the bar device includes a connector that connects the arched bar and the anchor. 
     In some applications, the anchor is a wire stent. 
     In some applications, the anchor is a pin fastener. 
     In some applications, the anchor is a wire fastener that clasps a wire. 
     In some applications, the connector comprises one or more of a rivet, suture, staple, wire, pin, shaft, sheet, mesh, housing, tubular member, cross-bar, etc. 
     In some applications, a sheet is extended from the arched bar. 
     In some applications, a gap filler/spacer/coaptation element is extended from the arched bar. 
     In some applications, the arched bar is a telescoping bar comprising an inner bar and an outer. The inner bar is capable of sliding within the outer bar such that the length of the telescoping bar is adjustable. 
     In some applications, a method is provided to deliver a system (e.g., a leaflet repair system, an arrestor system, a prolapse repair system, a flail repair system, a repair system, etc.) to a native valve (e.g., mitral valve, tricuspid valve, etc.) via transcatheter delivery. In some applications, the method includes guiding a puncture catheter or other puncture device (e.g., via a first guide wire, etc.) to vasculature of the heart (e.g., coronary sinus, coronary artery, etc.) adjacent a chamber of the heart (e.g., an atrium, a ventricle, etc.). The method includes puncturing the vasculature (e.g., coronary sinus, etc.) luminal wall and the chamber wall (e.g., atrium wall, etc.). The method includes guiding a delivery catheter (e.g., via a second guide wire, etc.) into the chamber (e.g., atrium, etc.) via the puncture in the vasculature (e.g., coronary sinus, etc.) luminal wall and the chamber wall (e.g., atrium wall, etc.). 
     In some applications, the method includes releasing a device (e.g., a repair device, a leaflet repair device, an arrestor, etc.) from the delivery catheter within the chamber (e.g., within the atrium, etc.). The method includes situating, using the delivery catheter, the device onto a portion of the leaflet (e.g., a posterior leaflet, etc.) of the native valve (e.g., mitral valve, tricuspid valve, etc.) that is experiencing prolapse or flail. 
     In some applications, the method includes releasing a connector or an interface and an anchor from the delivery system such that the anchor is within the vasculature (e.g., coronary sinus, etc.) and the connector or interface connects the device to the anchor traversing the vasculature (e.g., coronary sinus, etc.) luminal wall and the chamber wall (e.g., atrium wall, etc.). 
     In some applications, the delivery catheter reaches the vasculature (e.g., coronary sinus, etc.) via a transfemoral, a subclavian, a transapical, a transseptal, or a transaortic approach. 
     The above method(s) can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
     In some applications, a method is to deliver a compressive device (e.g., stent, clasp, form, etc.) to a native valve (e.g., mitral valve, etc.) via transcatheter delivery. In some applications, the method includes guiding a puncture catheter or other puncture device (e.g., via a first guide wire, etc.) to vasculature of the heart (e.g., coronary sinus, coronary artery, etc.) adjacent a chamber of the heart (e.g., an atrium, a ventricle, etc.). In some applications, the method incudes puncturing the vasculature luminal wall (e.g., coronary sinus luminal wall, coronary artery luminal wall, etc.) and the chamber wall (e.g., atrium wall, ventricular wall, etc.). 
     In some applications, the method includes guiding a delivery catheter (e.g., via a second guide wire, etc.) into the chamber (e.g., atrium, ventricle, left atrium, left ventricle, etc.) via the puncture in the vasculature luminal wall and the chamber wall. 
     In some applications, the method includes releasing a compressive device from the delivery catheter within the chamber (e.g., within the atrium or ventricle). 
     In some applications, the method includes using the delivery catheter (e.g., an actuator associated therewith) to compress the compressive device onto a portion of a posterior leaflet or other leaflet of the native valve (e.g., mitral valve, etc.) that is experiencing prolapse or flail. 
     In some applications, the method further includes releasing a connector or an interface and an anchor from the delivery system such that the anchor is within the vasculature (e.g., coronary sinus, etc.) and the connector or interface connects the compressive device to the anchor traversing the vasculature (e.g., coronary sinus, etc.) luminal wall and the chamber wall (e.g., atrium wall, etc.). 
     In some applications, the delivery catheter reaches the vasculature (e.g., coronary sinus, etc.) via a transfemoral, a subclavian, a transapical, a transseptal, or a transaortic approach. 
     In some applications, a gap filler/coaptation element/spacer system is configured for use within a heart valve. The gap filler/coaptation element/spacer system includes a gap filler, coaptation element, or spacer capable of expanding within gaps of a heart valve aperture when the valve is closed to fill any gaps in the valve and prevent or inhibit valvular regurgitation. The gap filler/coaptation element/spacer system includes an anchor capable of anchoring within vasculature. The gap filler/coaptation element/spacer system includes a connector or anchor receiver that connects the gap filler/coaptation element/spacer and the anchor. 
     In some applications, the gap filler/coaptation element/spacer comprises poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), or polycaprolactone (PCL). 
     In some applications, the anchor is a wire stent. 
     In some applications, the anchor is a pin fastener. 
     In some applications, the anchor is a wire fastener that clasps a wire. 
     In some applications, the connector or anchor receiver comprises one or more of a rivet, suture, staple, wire, pin, shaft, sheet, mesh, housing, tubular member, cross-bar, etc. 
     In some applications, the gap filler/coaptation element/spacer is configured to be implanted within a mitral valve, a tricuspid valve, an aortic valve, or a pulmonic valve. 
     In some applications, the anchor is configured to be implanted within vasculature nearby the valve, and wherein the connector traverses a chamber wall. 
     In some applications, the device (e.g., repair device, leaflet repair device, arrestor, etc.) is configured to be implanted within the mitral valve, the anchor is configured to be implanted within the coronary sinus, and the connector traverses the left atrium wall. 
     In some applications, the gap filler/coaptation element/spacer system further includes a delivery catheter. The gap filler/coaptation element/spacer, the connector, and the anchor are each compactable and/or otherwise configured to fit within the delivery catheter. 
     In some applications, the delivery catheter is configured to be delivered via a transfemoral, subclavian, transapical, transseptal, or transaortic approach. 
     The above method(s) can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
     In some applications, a system (e.g., a leaflet repair system, an arrestor system, a prolapse repair system, a flail repair system, a repair system, etc.) is for use within a heart valve for providing contact pressure onto a leaflet. The system includes a device (e.g., a repair device, a leaflet repair device, an arrestor, etc.) having a contact face capable of providing contact pressure onto an influent face of a heart valve leaflet. The system includes an anchor attached to the device capable of anchoring within tissue of the leaflet, the annulus, or chamber wall. 
     In some applications, the contact face can be contoured to help provide appropriate contact pressure. 
     In some applications, the contact face of the device has a length and a width to cover a prolapse or a flail of the heart valve leaflet. 
     In some applications, the contact face of the device is capable of providing contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the system includes a coaptation portion that is extended from the contact face. The coaptation portion is capable of extending the length of the device into coaptation area of the valve. 
     In some applications, the coaptation portion is capable of helping promote coaptation between the leaflets of the valve. 
     In some applications, the device is a wire form. 
     In some applications, the wire form is nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), polyethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), or fluorinated ethylene propylene (FEP). 
     In some applications, the wire form is compactible to fit within a delivery catheter. 
     In some applications, the wire form is self-expanding. 
     In some applications, the system includes undulating wire or intersecting wire to provide contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the system includes a sheet that is attached upon the wire form. The sheet forms the contact face. 
     In some applications, the sheet has a length and a width to cover a prolapse or a flail of the heart valve leaflet. 
     In some applications, the sheet is capable of providing contact pressure onto a prolapse or a flail of the heart valve leaflet. 
     In some applications, the device contains an impermeable coaptation portion and a permeable non-coaptation portion. 
     In some applications, the impermeable coaptation portion is thickened. 
     In some applications, the impermeable coaptation portion is capable of being thickened at the site of implantation. 
     In some applications, the sheet is poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), or polycaprolactone (PCL). 
     In some applications, the system includes a counterforce support opposite the coaptation area. 
     In some applications, the counterforce support is configured to engage a heart chamber wall. 
     In some applications, the anchor is a helical anchor, W-shaped anchor, a T-shaped anchor, or 1-turn spiral. 
     In some applications, the anchor is one or more helical anchors within a tubular compartment housing. The tubular compartment housing is connected the device. 
     In some applications, the one or more helical anchors is a single helical anchor coiled within itself that is compressed within the tubular compartment housing. 
     In some applications, the one or more helical anchors is two more helical anchors layered on top of one another in tandem and compressed within the tubular compartment housing. 
     In some applications, the one or more helical anchors is two more helical anchors comprising an inner helix (or inner helical anchor portion) and an outer helix (or outer helical anchor portion) and compressed within the tubular compartment housing. 
     In some applications, the two or more helical anchors are configured to embed within the tissue at two angles askew from each other. 
     In some applications, the system includes a fulcrum connected to the tubular compartment housing such that the plane of the device contact face is adjustable. 
     In some applications, the system includes a sliding mechanism incorporated on edges of the tubular compartment housing such that the plane of the device contact face is adjustable. 
     In some applications, the system includes a swing hinge or a soft hinge connected to the device. 
     In some applications, the device incorporates an internal gap in coaptation area of the device. The internal gap is free of wire form. 
     In some applications, the device incorporates a gap filler, coaptation element, or spacer. 
     In some applications, the gap filler/coaptation element/spacer comprises material selected from: foam, hydrogel, or silicone. 
     In some applications, the gap filler/coaptation element/spacer comprises a scissor mechanism or a coil. 
     In some applications, the device incorporates an expandable stent. 
     In some applications, the device is configured to be implanted within the mitral valve. 
     In some applications, the system includes a delivery catheter, wherein the device and the anchor are each compactable within the delivery catheter. 
     In some applications, the delivery catheter is configured to be delivered via a transfemoral, subclavian, transapical, transseptal, or transaortic approach. 
     In some applications, the device and the anchor are configured to be delivered via a transcatheter procedure through a coronary sinus to a mitral valve. 
     In some applications, a netting system is for used within a heart valve. The netting system includes a netting device having a netting with a contact face capable providing contact pressure onto an influent face of a heart valve leaflet. The lateral edges of the netting device are capable of situating within a heart valve crevice. The netting system includes an anchor attached to the netting and capable of anchoring within tissue of the leaflet, the annulus, or chamber wall. 
     In some applications, the netting is poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly hydroxybutyrate (P4HB), or polycaprolactone (PCL). 
     In some applications, the anchor is a helical anchor configured to be housed within a tubular compartment connected to the netting device. 
     In some applications, the netting system includes a tether that extends from a coaptation portion of the netting device. 
     In some applications, the netting system includes a wire form outlining the netting. 
     In some applications, the netting device is configured to be implanted within a mitral valve, a tricuspid valve, an aortic valve, or a pulmonic valve. 
     In some applications, the netting system includes a delivery catheter. The netting device and the anchor are each compactable within the delivery catheter. 
     In some applications, a method of repairing a native heart valve of a heart comprises advancing a delivery catheter transvascularly to the native heart valve, advancing an anchor (which can be the same as or similar to any anchors or securing features described herein) from the delivery catheter into tissue of the heart, thereby anchoring a leaflet repair implant/device (which can be the same as or similar to any implants/devices described herein) to the tissue, and releasing the leaflet repair implant/device from the delivery catheter, such that the leaflet repair implant/device extends along a portion of a leaflet of the native heart valve. 
     In some applications, advancing the anchor from the delivery catheter into tissue of the heart thereby anchoring the leaflet repair implant/device to the tissue is done prior to releasing the leaflet repair implant from the delivery catheter, such that the leaflet repair implant extends along a portion of the leaflet of the native heart valve. 
     In some applications, advancing the anchor from the delivery catheter into tissue of the heart thereby anchoring the leaflet repair implant to the tissue is done subsequently to releasing the leaflet repair implant from the delivery catheter, such that the leaflet repair implant extends along a portion of the leaflet of the native heart valve. 
     In some applications, advancing a delivery catheter transvascularly to the native heart valve is done via a transfemoral, a subclavian, a transapical, a transseptal, or a transaortic approach. 
     In some applications, advancing a delivery catheter transvascularly to the native heart valve is done via a transseptal approach across an atrial septum, and wherein the native heart valve is a mitral valve. 
     In some applications, the anchor is a helical anchor and advancing the anchor from the delivery catheter into tissue of the heart thereby anchoring the leaflet repair implant/device to the tissue includes rotating the helical anchor into the tissue. Other types of anchors are also possible. 
     In some applications, the tissue is part of an annulus of the native heart valve, and wherein rotating the helical anchor into the tissue includes rotating the helical anchor into the annulus of the native heart valve. 
     In some applications, releasing the leaflet repair implant/device from the delivery catheter, such that the leaflet repair implant/device extends along the portion of the leaflet of the native heart valve, includes releasing the leaflet repair implant/device from the delivery catheter, such that the leaflet repair implant/device extends along and applies a contact pressure to at least one of a prolapse portion of the leaflet and a flail portion of the leaflet. 
     In some applications, releasing the leaflet repair implant/device from the delivery catheter includes transitioning the leaflet repair implant/device from a compressed delivery configuration inside the delivery catheter to an expanded configuration outside of the delivery catheter. 
     In some applications, the leaflet repair implant/device is a contact pressure implant configured to apply a contact pressure to a native leaflet. The implant/device can be the same as or similar to any of the implants/devices described anywhere herein that apply a contract pressure to a leaflet of a native valve. 
     In some applications, the leaflet repair implant/device is a compressive implant/device and releasing the leaflet repair implant from the delivery catheter includes attaching the compressive implant/device to the leaflet such that a portion of the leaflet experiencing prolapse, flail, or rigidity is compressed between an influent side (e.g., a side attached to or in contact with an influent side of the leaflet) and an effluent side (e.g., a side attached to or in contact with an effluent side of the leaflet) of the compressive device. The compressive implant/device can be the same as or similar to any of the implants/devices described anywhere herein that apply a compressive force to or compress a leaflet of a native valve. 
     In some applications, the leaflet repair implant/device is a bar implant/device, and wherein releasing the leaflet repair implant from the delivery catheter includes securing ends of the bar device into commissures of the native heart valve. The bar implant/device can be the same as or similar to any of the implants/devices described anywhere herein that comprise a bar, elongate extension, arch, arched bar, etc. 
     In some applications, the leaflet repair implant/device is a netting implant/device releasing the leaflet repair implant/device from the delivery catheter includes releasing the netting implant/device from the delivery catheter. The netting implant/device can be the same as or similar to any of the implants/devices described anywhere herein that include a netting. 
     There is further provided, in accordance with some applications, a system and/or an apparatus for use with a valve of a heart of a subject (e.g., a native valve, mitral valve, tricuspid valve, other valve, etc.), the heart having a chamber upstream of the valve, and the system/apparatus including an implant, an anchor, a catheter, and a delivery tool. The implant can include an interface, and/or a flexible wing. The wing can be coupled to the interface. The wing can have a contact face and an opposing face opposite the contact face. The catheter is typically, transluminally advanceable to the chamber, and configured to house the implant. 
     The delivery tool can comprise a shaft, engaged with the interface. The shaft can be configured, via engagement with the interface, to deploy the implant out of the catheter such that, within the chamber, the wing extends away from the interface. Alternatively or additionally, the shaft can be configured to position the implant in a position in which the interface is at a site in the heart, the wing extends over a first leaflet of the heart toward at least one opposing leaflet (e.g., an opposing leaflet portion) of the heart, and the contact face faces the first leaflet. 
     The delivery tool can comprise a driver, engaged with the anchor, and configured to secure the implant in the position by using the anchor to anchor the interface to tissue of the heart. 
     In some applications, the implant does not include a downstream anchor. 
     In some applications, the implant includes exactly one anchor. 
     In some applications, the contact face is concave. 
     In some applications, the catheter is configured to house the implant while the wing is constrained within the catheter. 
     In some applications, the driver is configured to secure the implant in the position by using the anchor to anchor the interface at the site. 
     In some applications, the site is on an annulus of the valve, the delivery tool is configured to position the implant in the position in which the interface is at the site on the annulus, and the driver is configured to secure the implant in the position by using the anchor to anchor the interface to tissue of the annulus. 
     In some applications, the site is on a wall of the chamber, the delivery tool is configured to position the implant in the position in which the interface is at the site on wall of the chamber, and the driver is configured to secure the implant in the position by using the anchor to anchor the interface to tissue of the wall of the chamber. 
     In some applications, the chamber is an upstream chamber, the heart has a downstream chamber downstream of the valve, the delivery tool is configured to press the interface against the first leaflet such that the first leaflet becomes sandwiched between the delivery tool and a wall of the downstream chamber, and the driver is configured to anchor the interface by driving the anchor through the first leaflet and into the wall of the downstream chamber. 
     In some applications, the driver is configured to secure the implant in the position by driving the anchor through the first leaflet and into the tissue of the heart. 
     In some applications, the shaft is configured, via the engagement with the interface, to deploy the wing entirely out of the catheter, and the driver is configured to secure the implant in the position subsequently to the shaft deploying the wing entirely out of the catheter. 
     In some applications, the shaft is configured, via the engagement with the interface, to deploy the implant entirely out of the catheter, and the driver is configured to secure the implant in the position subsequently to the shaft deploying the implant entirely out of the catheter. 
     In some applications, the driver extends through the shaft. 
     In some applications, the shaft is configured, via the engagement with the interface, to deploy the implant out of the catheter while the driver is disposed within the shaft. 
     In some applications, the shaft is configured, via the engagement with the interface, to deploy the implant out of the catheter while the anchor is disposed within the shaft. 
     In some applications, the implant is configured to be housed within the catheter with the wing distal to the interface. 
     In some applications, the shaft is configured to deploy the implant out of the catheter such that the wing becomes exposed from the catheter prior to the interface. 
     In some applications, the implant includes an anchor receiver at the interface (e.g., the interface can comprise an anchor receiver), and the driver is configured to anchor the interface to the tissue by using the anchor to anchor the anchor receiver to the tissue. 
     In some applications, the interface defines a space therein, and the anchor receiver is disposed in the space. 
     In some applications, the implant includes a housing that defines at least part of the interface and at least part of the anchor receiver. 
     In some applications, the housing includes a lateral wall that circumscribes an aperture, and the lateral wall defines the interface. 
     In some applications, the housing defines an obstruction that protrudes at least partway across the aperture, and the driver is configured to anchor the interface to the tissue by driving the anchor through the housing until the anchor presses the obstruction toward the tissue. 
     In some applications, the lateral wall and the shaft define respective engagement elements, the shaft being engaged with the interface via engagement between the engagement elements of the shaft and the engagement elements of the lateral wall. 
     In some applications, the driver is configured to anchor the anchor receiver to the tissue by anchoring the anchor to the anchor receiver and to the tissue. 
     In some applications, the driver is configured to anchor the anchor to the anchor receiver by driving the anchor through the anchor receiver. 
     In some applications, the anchor includes a tissue-engaging element and a head, the anchor receiver defines an aperture therethrough, and includes an obstruction that protrudes medially into the aperture in a manner that facilitates passage of the tissue-engaging element through the aperture but inhibits obstructs passage of the head through the aperture, and the driver is configured to anchor the anchor to the anchor receiver by driving the tissue-engaging element through the anchor receiver until the head of the anchor becomes obstructed by the obstruction. 
     In some applications, the obstruction includes a cross-bar that traverses the aperture. 
     In some applications, the obstruction includes a collar. 
     In some applications, the obstruction includes a sheet that is penetrable by the tissue-engaging element. 
     In some applications, the tissue-engaging element is a helical tissue-engaging element, and the driver is configured to drive the tissue-engaging element through the anchor receiver by screwing the tissue-engaging element through the anchor receiver. 
     In some applications, the position is a first position, the site is a first site, and via the engagement with the interface, the shaft is configured to, after placing the implant in the first position, reposition the implant into a second position in which the interface is at a second site in the heart, the wing extends over the first leaflet toward the opposing leaflet, and the contact face faces the first leaflet, the second position being different from the first position, and the second site being different from the first site. 
     In some applications, the shaft is configured to reposition the implant into the second position while the wing remains entirely outside of the catheter. 
     In some applications, the shaft is configured to reposition the implant into the second position while the implant remains entirely outside of the catheter. 
     In some applications, the wing includes a frame and a sheet spread over the frame. 
     In some applications, the frame includes at least one frame material selected from the group consisting of: of nitinol, cobalt-chrome, stainless steel, titanium, polyglycolic acid, polylactic acid, poly-D-lactide, polyurethane, poly-4-hydroxybutyrate, polycaprolactone, polyether ether ketone, a cyclic olefin copolymer, polyethylene vinyl acetate, polytetrafluorethylene, a perfluoroether, and fluorinated ethylene propylene. 
     In some applications, the frame is compactible to fit within the catheter. 
     In some applications, the frame is self-expanding. 
     In some applications, the frame is attached to the interface. 
     In some applications, the sheet includes at least one sheet material selected from the group consisting of: poly(lactic-co-glycolic) acid, polyvinylchloride, polyethylene, polypropylene, polytetrafluoroethylene, polyurethane, polyethylene terephthalate, polyethersulfone, polyglycolic acid, polylactic acid, poly-D-lactide, poly-4-hydroxybutyrate, and polycaprolactone. 
     In some applications, the wing has a root that is coupled to the interface, a tip at an opposite end of the wing from the root, and two lateral sides extending from the root to the tip. 
     In some applications, the chamber is an upstream chamber, the heart has a downstream chamber downstream of the valve, and an angular disposition of the wing with respect to the interface is such that positioning, by the shaft, of the implant in the position disposes the tip within the downstream chamber. 
     In some applications, the first leaflet has a lip, and an angular disposition of the wing with respect to the interface is such that positioning, by the shaft, of the implant in the position disposes the tip downstream of the lip of the first leaflet. 
     In some applications, the frame defines two loops extending from the root alongside each other. 
     In some applications, the two loops extend alongside each other from the root to the tip. 
     In some applications, the frame connects the two loops to each other only at the interface. 
     In some applications, the sheet is spread over the frame such that the sheet extends over and between the two loops. 
     In some applications, each of the loops circumscribes a space that is substantially absent of frame components. 
     In some applications, each of the loops is substantially teardrop-shaped. In some applications, each of the loops is substantially oval, ovoid, or triangular. 
     In some applications, the wing is curved in the direction of the valve leaflet. In some applications, the wing curves from the interface in one direction and then curves in the opposite direction moving toward the end. 
     In some applications, the frame defines an elongate space between the two loops, extending from the root toward the tip, and the sheet is spread over the frame such that the sheet extends across the two loops and the space. 
     In some applications, the elongate space runs along a plane of reflectional symmetry of the wing. 
     In some applications, the elongate space extends from the root to the tip, such that the frame does not bridge the two loops at the tip. 
     In some applications, the sheet has a plurality of holes therethrough. 
     In some applications, the holes are polygonal and are tessellated. 
     In some applications, the holes are hexagonal. 
     In some applications, a curvature of the wing is such that, in a cross-section of the implant through the interface and the wing, the contact face is concave. 
     In some applications, in the cross-section of the implant, the curvature of the wing increases with distance from the interface. 
     In some applications, the cross-section is in a plane of reflectional symmetry of the implant. 
     In some applications, the implant further includes a counterforce support, extending from the interface and away from the wing. 
     In some applications, the counterforce support is shaped such that, in the position, the counterforce support lies against a wall of the chamber. 
     In some applications, the catheter has a distal opening, and is configured to house the implant with the wing disposed distally from the interface, and the interface disposed distally from the counterforce support. 
     In some applications, the counterforce support includes a wire loop. 
     In some applications, the shaft is configured to be engaged with the interface within the catheter such that the shaft extends, within the catheter, proximally away from the interface and past the counterforce support. 
     In some applications, the anchor is a first anchor, and the system/apparatus further includes a second anchor that is configured to anchor the interface to the tissue. 
     In some applications, the driver is configured to secure the implant in the position by using the second anchor to anchor the interface to the tissue. 
     In some applications, the driver is a first driver, and the delivery tool further includes a second driver, engaged with the second anchor, and configured to secure the implant in the position by using the second anchor to anchor the interface to the tissue. 
     In some applications, the anchor includes a helical tissue-engaging element, and the driver is configured to secure the implant in the position by screwing the tissue-engaging element into the tissue. 
     In some applications, the tissue-engaging element is a first tissue-engaging element, and the anchor further includes a second helical tissue-engaging element, the first tissue-engaging element and the second tissue-engaging element arranged as a double helix. 
     In some applications, the anchor has a proximal end and a distal end, and each of the first tissue-engaging element and the second tissue-engaging element has a sharpened distal tip at the distal end of the anchor, and is shaped as a conic helix that widens toward the distal end of the anchor. 
     In some applications, the first tissue-engaging element is defined by a first wire, and the second tissue-engaging element is defined by a second wire. 
     In some applications, along a longitudinal axis of the anchor, the anchor has: a tissue-engaging region in which: a first wire defines the first tissue-engaging element, a second wire defines the second tissue-engaging element, and the first wire and the second wire each has a tissue-engaging pitch that is such that, within the double helix, turns of the first wire are axially spaced apart from turns of the second wire. 
     In some applications, the anchor also has a head region in which the first wire and the second wire each has a head pitch that is such that, within the double helix, turns of the first wire abut turns of the second helix. The head region can also be arranged along the longitudinal axis of the anchor. 
     In some applications, the tissue-engaging pitch of the first wire is at least 4 times greater than a thickness of the first wire. 
     In some applications, the anchor includes a wire that has a sharpened distal tip. In some applications, the wire has: a first helical portion that has a first pitch, and that defines a head of the anchor, and a second helical portion that has a second pitch that is greater than the first pitch, that defines the tissue-engaging element, and that terminates at the sharpened distal tip. In some applications, the first pitch configures the first helical portion to resist being screwed into the tissue. 
     In some applications, the contact face is shaped to define leaflet-thickening elements, configured to induce thickening of the first leaflet where the wing extends over the first leaflet. 
     In some applications, the leaflet-thickening elements include protrusions. 
     In some applications, the leaflet-thickening elements include recesses. 
     There is further provided, in accordance with some applications, a method for use with a valve of a heart of a subject (e.g., a native valve, mitral valve, tricuspid valve, other valve, etc.), the heart having a chamber upstream of the valve, and the method including, within a catheter, advancing to the chamber (1) an implant that includes an interface and a flexible wing coupled to the interface, the wing having a contact face, and an opposing face opposite the contact face, and (2) a shaft engaged with the interface. 
     In some applications, the method further comprises, using the shaft to deploy the implant out of the catheter such that, within the chamber, the wing extends away from the interface. 
     In some applications, the method further comprises subsequently, using the shaft, positioning the implant in a position in which the interface is at a site in the heart, the wing extends over a first leaflet of the valve toward at least one opposing leaflet (e.g., an opposing leaflet portion) of the valve, and the contact face faces the first leaflet. 
     In some applications, the method further comprises subsequently securing the implant in the position by anchoring the interface to tissue of the heart. 
     In some applications, advancing the implant to the chamber includes advancing the implant to the chamber while the wing is constrained within the catheter. 
     In some applications, the wing has a root that is coupled to the interface, and a tip at an opposite end of the wing from the root, the chamber is an upstream chamber, the heart has a downstream chamber downstream of the valve, and positioning the implant in the position includes positioning the implant such that the tip is disposed within the downstream chamber. 
     In some applications, the wing has a root that is coupled to the interface, and a tip at an opposite end of the wing from the root. In some applications, the first leaflet of the valve has a lip, and positioning the implant in the position includes positioning the implant such that the tip is disposed downstream of the lip of the first leaflet. 
     In some applications, the contact face is concave, and positioning the implant in the position includes positioning the implant such that the concave contact face contacts the first leaflet. 
     In some applications, positioning the implant in the position includes positioning the implant such that the opposing face contacts the opposing leaflet. 
     In some applications, the valve is a mitral valve of the heart, the chamber is a left atrium of the heart, and advancing the implant to the chamber includes advancing the implant to the left atrium. 
     In some applications, the valve is a tricuspid valve of the heart, the chamber is a right atrium of the heart, and advancing the implant to the chamber includes advancing the implant to the right atrium. 
     In some applications, the valve is an aortic valve of the heart, the chamber is a left ventricle of the heart, and advancing the implant to the chamber includes advancing the implant to the left ventricle. 
     In some applications, the valve is a pulmonary valve of the heart, the chamber is a right ventricle of the heart, and advancing the implant to the chamber includes advancing the implant to the right ventricle. 
     In some applications, the site is on an annulus of the valve, and anchoring the interface to the tissue of the heart includes anchoring the interface to tissue of the annulus. 
     In some applications, the site is on a wall of the chamber, and anchoring the interface to the tissue of the heart includes anchoring the interface to tissue of the wall of the chamber. 
     In some applications, anchoring the interface to the tissue of the heart includes pinning the first leaflet to the tissue of the heart. 
     In some applications, the chamber is an upstream chamber, the heart has a downstream chamber downstream of the valve, positioning the implant in the position includes pressing the interface against the first leaflet such that the first leaflet becomes sandwiched between the delivery tool and a wall of the downstream chamber, and securing the implant in the position includes driving an anchor through the first leaflet and into the wall of the downstream chamber. 
     In some applications, anchoring the interface to the tissue includes using a driver to drive an anchor into the tissue. 
     In some applications, the anchor includes a tissue-engaging element, and using the driver to drive the anchor into the tissue includes using the driver to screw the tissue-engaging element into the tissue. 
     In some applications, the implant includes an anchor receiver at the interface, and the method further includes using the driver to anchor the anchor to the anchor receiver. 
     In some applications, anchoring the interface to the tissue includes using the driver to drive the anchor through the anchor receiver and into the tissue. 
     In some applications, the anchor includes a tissue-engaging element and a head, the anchor receiver defines an aperture therethrough, and includes an obstruction that protrudes medially into the aperture, and using the driver to drive the anchor through the anchor receiver and into the tissue includes using the driver to drive the tissue-engaging element beyond the obstruction until the head of the anchor becomes obstructed by the obstruction. 
     In some applications, the obstruction includes a cross-bar that traverses the aperture, and using the driver to drive the tissue-engaging element beyond the obstruction until the head of the anchor becomes obstructed by the obstruction includes using the driver to drive the tissue-engaging element beyond the cross-bar until the head of the anchor becomes obstructed by the cross-bar. 
     In some applications, the obstruction includes a collar, and using the driver to drive the tissue-engaging element beyond the obstruction until the head of the anchor becomes obstructed by the obstruction includes using the driver to drive the tissue-engaging element beyond the collar until the head of the anchor becomes obstructed by the collar. 
     In some applications, the obstruction includes a flexible sheet, and using the driver to drive the tissue-engaging element beyond the obstruction until the head of the anchor becomes obstructed by the obstruction includes using the driver to pierce the sheet with the tissue-engaging element, and to drive the tissue-engaging element through the sheet until the head of the anchor becomes obstructed by the sheet. 
     In some applications, the implant includes a housing that includes a lateral wall that circumscribes an aperture, the lateral wall defining at least part of the interface, and positioning the implant in the position includes positioning the implant in the position using the shaft while the shaft is engaged with the lateral wall. 
     In some applications, the implant defines an obstruction that protrudes at least partway across the aperture, and anchoring the interface to the tissue includes anchoring the housing to the tissue by using the driver to drive the anchor through the housing until the anchor presses the obstruction toward the tissue. 
     In some applications, the implant further includes a counterforce support, and deploying the implant out of the catheter includes deploying the implant out of the catheter such that the counterforce support extends from the interface and away from the wing. 
     In some applications, the position is a position in which the counterforce support lies against a wall of the chamber, and positioning the implant in the position includes positioning the implant in the position in which the counterforce support lies against the wall of the chamber. 
     In some applications, deploying the implant out of the catheter includes deploying, out of the catheter, the wing, followed by the interface, followed by the counterforce support. 
     In some applications, deploying the implant out of the catheter includes deploying the wing out of the catheter while the shaft extends, within the catheter, proximally away from the interface and past the counterforce support. 
     In some applications, positioning the implant in the position includes positioning the implant in the position subsequently to deploying the wing entirely out of the catheter. 
     In some applications, positioning the implant in the position includes positioning the implant in the position subsequently to deploying the implant entirely out of the catheter. 
     In some applications, the position is a first position, the site is a first site, and the method further includes, after placing the implant in the first position, repositioning the implant into a second position in which the interface is at a second site in the heart, the wing extends over the first leaflet toward the opposing leaflet, and the contact face faces the first leaflet, the second position being different from the first position, and the second site being different from the first site. 
     In some applications, the first site is a first site on an annulus of the valve and the second site is a second site on the annulus of the valve. 
     In some applications, repositioning the implant into the second position includes, using the shaft, sliding the interface along the annulus. 
     In some applications, repositioning the implant into the second position includes, using the shaft, lifting the interface away from the annulus at the first site, and replacing the interface against the annulus at the second site. 
     In some applications, repositioning the implant into the second position includes repositioning the implant into the second position prior to anchoring the interface to the tissue. 
     In some applications, the method further includes, subsequently to anchoring the interface to the tissue, de-anchoring the interface from the tissue, repositioning the implant into the second position includes repositioning the implant into the second position subsequently to de-anchoring the interface from the tissue, and the method further includes, subsequently to repositioning the implant into the second position, re-anchoring the interface to the tissue. 
     In some applications, the method further includes receiving information indicative of regurgitation through the valve while the implant is positioned at the first position, and repositioning the implant into the second position includes repositioning the implant into the second position responsively to receiving the information. 
     In some applications, the information is echocardiographic information, and repositioning the implant into the second position includes repositioning the implant into the second position responsively to receiving the echocardiographic information. 
     In some applications, repositioning the implant into the second position includes repositioning the implant into the second position while the wing remains entirely outside of the catheter. 
     In some applications, repositioning the implant into the second position includes repositioning the implant into the second position while the implant remains entirely outside of the catheter. 
     In some applications, the deploying the implant out of the catheter includes deploying the implant out of the catheter while the driver is disposed within the shaft. 
     In some applications, the deploying the implant out of the catheter includes deploying the implant out of the catheter while the anchor is disposed within the shaft. 
     The above method(s) can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
     The present invention will be more fully understood from the following detailed description of applications thereof, taken together with the drawings, in which: 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a schematic illustration of the left chambers of a heart as a reference for various embodiments; 
         FIG.  2    is a schematic illustration of a mitral valve as a reference for various embodiments; 
         FIGS.  3  and  4    are schematic illustrations of a heart valve leaflet flail and a heart valve leaflet prolapse, respectively, as a reference for various embodiments; 
         FIGS.  5 - 9 ,  10 A -C, and  11 - 13  are schematic illustrations of various example devices implanted on native valves; 
         FIGS.  14  and  15    are schematic illustrations of an example gap filler, coaptation element, or spacer device implanted on a native valve; 
         FIGS.  16 A-D  are schematic illustrations of example anchors for use within vasculature; 
         FIGS.  17 A-E  are schematic illustrations of example anchors for use within a heart valve; 
         FIGS.  18 A-H  are schematic illustrations of example helical anchors; 
         FIGS.  19 A-C  are schematic illustrations of an example system having a device with an adjustable contact-face angle; 
         FIGS.  20 A-B ,  21 A-B,  22 A-C,  23 A-D,  24 A-D, and  25 - 30  are schematic illustrations of example devices in accordance with some applications; 
         FIGS.  31 A- 31 L  are schematic illustrations of an example method to deliver a device to a native valve via a transcatheter procedure; 
         FIGS.  32 - 35    are schematic illustrations of example compressive devices implanted on a native valve; 
         FIGS.  36 - 59    are schematic illustrations of example compressive devices; 
         FIGS.  60 A- 60 D  are schematic illustrations of an example method to deliver a compressive device to a native valve via a transcatheter procedure; 
         FIGS.  61 - 63    are schematic illustrations of example repair devices including a bar; 
         FIGS.  64 - 66    are schematic illustrations of example repair devices including netting or mesh; 
         FIGS.  67 A-B ,  68 A-G,  69 - 71 ,  72 A-C, and  73 - 75  are schematic illustrations of a system for use with a valve of a heart of a subject, in accordance with some applications; 
         FIG.  76    is a schematic illustration of an implant, in accordance with some applications; 
         FIGS.  77 A-B  are schematic illustrations of an implant, in accordance with some applications; and 
         FIGS.  78 A-B  and  79  are schematic illustrations of anchors, in accordance with some applications. 
     
    
    
     DETAILED DESCRIPTION 
     Systems, apparatuses, devices, methods, etc. for mitigating heart valve regurgitation are described herein. In some applications, systems, apparatuses, devices, methods, etc. include implants/devices that situate within the valvular annulus and anchor within the annulus and/or nearby vasculature. The systems, apparatuses, devices, methods, etc. can be configured to provide contact pressure onto and/or support to the leaflet region experiencing flail, prolapse, rigidity, etc. In some applications, systems, apparatuses, devices, methods, etc. capable of compressing onto a leaflet and providing contact pressure onto and/or support to the leaflet region experiencing flail, prolapse, rigidity, etc. are described, e.g., compressive devices, clasps, splints, forms, etc. In some applications, systems, apparatuses, devices, etc. are described that further anchor to into the leaflet annulus or a nearby vasculature, the systems, apparatuses, devices, etc. providing contact pressure onto and/or support to the leaflet region experiencing flail, prolapse, rigidity, etc. Various examples of methods of delivering to and implanting systems, apparatuses, devices, etc. at the site of flail, prolapse, rigidity, etc. are described. An example of where these can be helpful is when used at the posterior leaflet of a mitral valve experiencing flail, prolapse, rigidity, and/or another issue. 
     The described systems, apparatuses, devices, methods, etc. should not be construed as limiting in any way. Instead, the present disclosure is directed toward all novel and nonobvious features and aspects of the various disclosed implementations and applications, alone and in various combinations and sub-combinations with one another. The disclosed systems, apparatuses, devices, methods, etc. are not limited to any specific aspect, feature, or combination thereof, nor do the disclosed systems, apparatuses, devices, methods, etc. require that any one or more specific advantages be present or problems be solved. Further, the techniques, methods, operations, steps, etc. described or suggested herein can be performed on a living animal (e.g., human, other mammal, etc.) or on a non-living simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, tissue, etc. being simulated), anthropomorphic phantom, etc. 
     Various implementations of systems, devices, examples of prosthetic implants, etc. are disclosed herein, and any combination of the described features, components, and options can be made unless specifically excluded. For example, various descriptions of anchors, can be used with any appropriate prosthetic device, and/or delivered and implanted by any appropriate method, even if a specific combination is not explicitly described. Likewise, the different constructions and features of devices and systems can be mixed and matched, such as by combining any implant device type/feature, attachment type/feature, site of repair, etc., even if not explicitly disclosed. In short, individual components of the disclosed systems can be combined unless mutually exclusive or physically impossible. 
     Although the operations of some of the disclosed methods are described in a particular, sequential order for convenient presentation, it should be understood that this manner of description encompasses rearrangement, unless a particular ordering is required by specific language set forth below. For example, operations described sequentially can in some cases be rearranged or performed concurrently. Moreover, for the sake of simplicity, the attached figures may not show the various ways in which the disclosed systems, apparatuses, devices, methods, etc. can be used in conjunction with other systems, apparatuses, devices, methods, etc. 
       FIG.  1    is a coronal-plane view within the left chambers sectioning through the coaptation area of the mitral valve and  FIG.  2    is a traverse-plane view within the left atrium superior to the mitral valve. The left ventricle (LV) is separated from the left atrium (LA) mitral valve (MV). Each of the four valves of the heart has flexible leaflets extending inward across the respective orifices that come together or “coapt” in the bloodstream to form the one-way, fluid-occluding surfaces. Accordingly, referring back to the left chambers, oxygenated blood is brought to the left atrium from the pulmonary vein (not shown) and then transferred across the mitral valve into the left ventricle. The left ventricle pumps the oxygenated passing through the aortic valve, into the aorta, and throughout the body. 
     Also shown in  FIG.  1    are the papillary muscles (PM), which are attached to the left ventricle wall and connected to the mitral valve (MV) leaflets via the chordae tendineae (CT). These muscles and cords assist in the function of the mitral valve (MV) to open the leaflets to form an aperture, to coapt the leaflets to close the aperture, and to maintain leaflet shape and position. 
       FIG.  1    also shows the coronary sinus (CS), which is a vasculature that surrounds the left ventricle. Throughout the disclosure, the coronary sinus is used as an example as a nearby vasculature site for docking anchors for various implementations described. 
       FIG.  3    provides an example of leaflet flail and  FIG.  4    provides an example of leaflet prolapse. Leaflet flail occurs when the coapting portion of the leaflet flips backwards against blood flow. Likewise, leaflet prolapse occurs when a portion of the leaflet protrudes backward. Flail and prolapse can occur due to various conditions, including (but not limited to) papillary muscle (PM) and/or chordae tendineae (CT) dysfunction. In the examples provided in  FIG.  3    and  FIG.  4   , breaks in the chordae tendineae (CT) result in leaflet flail and prolapse, respectively. Leaflet flail and prolapse can also occur due to the chordae tendineae (CT) stretching out. Leaflet flail, prolapse, rigidity, and/or other leaflet issues can result in a failure of coaptation, resulting in regurgitant blood flow. 
     Throughout the document, description and drawings often refer to the left chambers, and specifically to the mitral valve (MV) and coronary sinus (CS), as examples for the various implementations described. It is to be noted, however, that the various implementations and applications described can be utilized on other valves (e.g., tricuspid valve, pulmonary valve, aortic valve, etc.) and other vasculature (e.g., coronary artery, etc.) mutatis mutandis, as can be appreciated by those skilled in the art. 
     Several implementations and applications herein are directed towards systems, apparatuses, devices, etc. (e.g., leaflet repair systems, arrestor systems, prolapse repair systems, flail repair systems, repair systems, etc.) that arrest or otherwise treat valve leaflet issues, such as flail, prolapse, rigidity, etc. In some applications, a system, apparatus, device, etc. herein is capable of being situated at the influent side of a valve such that it can apply contact pressure or support onto a region of flail, prolapse, rigidity, etc. The contact pressure or support provided by various implementations can help flatten out and/or reshape the flail, prolapse, rigidity, and/or abnormality, which helps to extend the coapting edge of a leaflet back towards the coaptation area when in a closed position. Proper coaptation that results in a fully closed valve prevents valve regurgitation. In some applications, the system, apparatus, device, etc. is configured to support, arrest, and/or depress a leaflet to prevent the leaflet from flailing or flipping towards the influent side of the valve. Likewise, in some applications, the system, apparatus, device, etc. is configured to support, arrest, and/or depress a leaflet to prevent the leaflet from prolapsing or from protruding or bulging towards the influent side of the valve. 
     In some applications, a system, apparatus, device, etc. herein (e.g., leaflet repair system, arrestor system, prolapse repair system, flail repair system, repair system, etc.) includes (but is not limited to) one face that is to directly contact the face of a leaflet experiencing leaflet issues, e.g., flail, prolapse, rigidity, etc. Typically, the influent face of a leaflet is the face that experiences flail, prolapse, rigidity, and/or other issues. In some applications, the contact face of the device is contoured to the influent face of a leaflet, which can be a hyperbolic paraboloid-like contour. In some applications, the contact face of the system/device provides contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. In some applications, the contact face has a width and a length such that it can cover the region of the leaflet experiencing flail, prolapse, rigidity, and/or abnormality. In some applications, the length of the system/device extends into the coaptation area of the leaflet. In some applications, the coaptation portion of the system/device helps promote coaptation of the leaflets when closed. 
     In some applications, the system, apparatus, device, etc. herein includes an anchor to stabilize the system/device at the site of implantation. In some applications, a system/device includes a portion that is in connection with the anchor. In some applications, the anchor connection point (e.g., anchor receiver, etc.) is near or in contact with the valve annulus or a ventricle or atrium wall. In some applications, an anchor connection point includes a hinge capable of adjusting the plane of the contact face of the system/device relative to the anchoring point. In some applications, a swing hinge is utilized. In some applications, a hinge is made of soft compliable material (e.g., cloth or mesh) such that the plane of the system/device contact face is adjustable relative to the anchoring point. In some applications, a fulcrum is incorporated at the anchoring point such that the plane of the contact face is adjustable relative to the anchoring point. In some applications, sliding mechanisms are incorporated at the edges of the anchoring point such that the plane of the contact face is adjustable relative to the anchoring point. 
     In some applications, the anchor connection point or anchor receiver is configured as an interface. The interface can connect with a catheter or shaft for delivering and positioning the system/device. 
     In some applications, an anchor is situated near or in contact with the valve annulus, leaflet area, or atrium/ventricle wall. In some applications, an anchor is a helical anchor, screw, or other feature capable of screwing/rotating within or embedding within the valve annulus, leaflet, or atrium/ventricle wall. 
     In some applications, a helical anchor is housed within a tubular compartment, the tubular compartment connected to or a part of the device to be anchored. In some applications, the tubular compartment includes one, two, or more helixes or helical anchor portions therein to anchor the device. In some applications, the helix(es) or helical anchor portion(s) are pushed through the tubular compartment to screw or rotate within the tissue at the anchoring site. In some applications, the helix(es) or helical anchor portion(s) are compressible (e.g., like a spring) within the tubular compartment such that the tubular compartment maintains a low profile; the helix(es) or helical anchor portion(s) are decompressed as the helix(es) or helical anchor portion(s) are screwed or rotated within the tissue at the anchoring site. In some applications having a single helix or helical anchor portion within the housing, the helix or helical anchor portion is coiled within itself to maintain a very low profile. In some applications having two or more helix(es) or helical anchor portion(s) within the housing, the helix(es) or helical anchor portion(s) are layered on top of one another in tandem. In some applications having two or more helix(es) or helical anchor portion(s) within the housing, one helix or helical anchor portion is radially within the other helix or helical anchor portion such that there is at least one an inner helix or inner helical anchor portion and at least one outer helix or outer helical anchor portion. In some applications having two or more helix(es) or helical anchor portion(s) within the housing, the helix(es) or helical anchor portion(s) are configured to embed within the tissue at the anchoring site at two angles askew from each other. 
     In some applications, an anchor is situated near or in contact with the ventricle or atrium wall on the opposite side of the wall from the anchor connection point (e.g., within nearby vasculature). In some applications, a connector is utilized to connect the anchor, the connector traversing through the ventricle or atrium wall. Any appropriate connector can be utilized, such as (for example) a screw, rivet, suture, staple, wire, pin, or shaft. In some applications, a connector wire is utilized such that the wire tension between the device and the anchor is taut. 
     In some applications, an anchor is situated within vasculature that is on the opposite side of a chamber (i.e., ventricle or atrium) wall. For example, various implant or device implementations herein are configured to mitigate leaflet issues, such as flail, prolapse, and/or rigidity, of the mitral valve and thus are situated within the left atrium. In these various implementations, a device can be connected with an anchor situated within the coronary sinus utilizing a connector traversing through the atrial wall. Any appropriate anchor can be utilized. In some applications, an anchor is wire stent or wire form capable of expanding within vasculature. In some applications, an anchor is a pin fastener (e.g., R-pin, etc.) or wire fastener capable of pinning a device via a connector to the ventricle or atrium wall. In some applications, a pin or wire fastener is utilized on the opposite side of a ventricle or atrium wall and the connector traverses the wall. In some applications, a pin fastener is utilized within vasculature that is on the opposite of a ventricle or atrium wall. In some applications, a wire fastener is capable of pinching a connector wire to hold the wire in place and create tension between the wire fastener anchor and the device. 
     In some applications, a system and/or device is anchored utilizing a T-shaped anchor capable of fitting within and clinging to a crevice within the heart valve (e.g., cleft or commissure). In some applications, a T-shaped anchor has two arms (i.e., the cross portion of the T-shape) and connecting portion (i.e., the vertical portion of the T-shape). In some applications, the connecting portion is connected to a device to hold the device at the site of deployment. In some applications, the two arms are capable of contracting and expanding; in a contracted state the two arms are parallel (or near parallel) with the connecting portion and in the expanded state the two arms are orthogonal (or near orthogonal) with the connecting portion. In some applications, when the anchored is deployed, the two arms enter into the crevice in a contracted state and are expanded within a crevice within the heart valve and under the leaflet such that it is secured within the crevice. 
     In some applications, a system, implant, and/or device herein is additionally directly anchored or fastened to the leaflet experiencing issues, e.g., flail, prolapse, rigidity, and/or other issues. In some applications, an anchor is a pin fastener (e.g., R-pin, R-key, etc.) or wire fastener capable of pinning a device via a connector to the leaflet. In some applications, a pin or wire fastener is utilized on the effluent side of a leaflet (e.g., a ventricular side of an atrioventricular valve leaflet) and the connector traverses through the leaflet. In some applications, an anchored system/device has a length that extends from the anchor to the coapting edge of a leaflet, where a clamp is utilized to anchor the system/device to the leaflet edge by pinching or compressing the device edge and leaflet edge together. 
     In some applications, a system and/or device herein incorporates a tether or artificial chord for further stabilization at the site of implantation. In some applications, a tether or chord extends from the coaptation portion of a device to a pinning location on the effluent side of the valve, where the tether is pinned down. The pinning location can be any sturdy feature, such as (for example) ventricle wall, atrium wall, papillary muscle, and/or nearby vasculature. 
     In some applications, a system and/or device herein (e.g., leaflet repair system/device, arrestor system/device, prolapse repair system/device, flail repair system/device, repair system/device, etc.) comprises wire form frame and/or a wire form device (e.g., a device comprising a wire form frame). Any appropriate material to produce a wire form can be utilized, including (but not limited to) nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), poly ethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), fluorinated ethylene propylene (FEP), additives thereof, and derivatives thereof. In some applications, a wire form device or wire form frame is contractible, which is useful to fit within a catheter in a more compact or collapsed configuration for less invasive catheter delivery methodologies. In some applications, nitinol is utilized for its self-expanding properties, which can be useful to implant the device in less invasive catheter delivery methodologies. 
     Various shapes of wire form devices or wire form frames can be utilized in various different implementations and applications. In some applications, a wire form frame/device is shaped to have portions of the wire form provide contact pressure or support on the leaflet issue, e.g., on the flail, prolapse, and/or rigidity of a leaflet. In some applications, a wire form frame/device has length and width to surround an area of flail or prolapse and utilizes a sheet extending across the area to provide contact pressure on the flail, prolapse, rigidity, etc. In some applications, a wire form frame or wire form device has length and width to surround an area of flail or prolapse and utilizes wire that undulates or intersects across the area to provide contact pressure on the flail, prolapse, rigidity, etc. In some applications, a wire form frame or wire frame device is free of wire at an internal portion of the coaptation area devoid of wire such that any future procedures that may be needed at some later time can still be performed on the native leaflet coaptation area (e.g., edge to edge repair, such as suturing or clamping leaflet edges together). In some applications, a wire form frame or wire form device includes a support or counterforce support extending from the portion of the wire form device opposite of the coaptation area, which can help the wire form device provide contact pressure on the flail, prolapse, rigidity, etc. In some applications, the support or counterforce support is configured to contact a heart chamber wall (e.g., atrium or ventricle wall). In some applications, a wire form device includes an indentation or hook formed via the wire, which can help secure the device within the site of implantation by fitting within or hooking onto the commissures, clefts or other similar valve areas. 
     In some applications, a system and/or device herein (e.g., leaflet repair system/device, arrestor system/device, prolapse repair system/device, flail repair system/device, repair system/device, etc.) incorporates a sheet attached on a wire form capable of forming a contact face. In some applications, a sheet provides a surface capable of providing contact pressure or support onto a leaflet experiencing issues, such as flail, prolapse, and/or rigidity. A sheet can be impermeable, semipermeable, or permeable to fluids (e.g., blood or plasma). In some applications, the sheet is a mesh. In some applications, a mesh is formed utilizing interleaving strings that overlap and intersect. A mesh or permeable sheet can beneficially provide contact pressure/support without restricting the flow of blood or plasma, which can be important in various applications. For instance, an impermeable sheet may trap blood or plasma between the device and leaflet, which in turn might create undesired pressures with the valve and/or create pressures that dislodges the device or alters its position. In some applications, the sheet is partially an impermeable material and partially a permeable mesh. For instance, in some applications, a cooptation portion of a system/device herein utilizes an impermeable material while a non-coaptation portion of the device utilizes a permeable mesh. In some applications, the impermeable coaptation portion helps promote proper closure of a native valve when coapting. In some applications, a mesh is formed utilizing a mesh sheet. Any appropriate material can be utilized for a sheet and/or mesh, including (but not limited to) poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), and polycaprolactone (PCL). Any appropriate means to attach a sheet and/or mesh onto a wire form can be utilized, including (but not limited to) stitching, staples, and glue. Optionally, in some applications, the sheet is a form-fitted cover that stretches across the wire form or wire form frame. 
     In some applications, a wire form device or a system/device having a wire form frame has a static portion and a dynamic portion. In some applications, the static portion is capable of situating within the valve and can include indents and or hooks to secure the device within the site of implantation by fitting with or hooking onto the commissures or other similar leaflet areas. In some applications, the dynamic portion includes a sheet to help provide contact pressure on and/or support to a leaflet, e.g., to address flail, prolapse, rigidity, etc. In some applications, the dynamic portion is capable of being repositioned and/or resized during the implantation process such that it can be adequately cover the leaflet region experiencing the flail, prolapse, rigidity, and/or other issue. 
     In some applications, the systems/devices are configured to help promote coaptation of the leaflets when closed. In some applications, a gap filler, coaptation element, or spacer is incorporated with the system/device. In some applications, the gap filler, coaptation element, or spacer extends from or within the coaptation portion, which can help fill gaps within the valve aperture. In some applications, the system/device includes an extended portion with an impermeable sheet that extends from the leaflet lip into the aperture, which can help form coaptation with the other leaflet(s). In some applications, the system/device includes an extended portion that is thickened, which acts as gap filler or spacer to help fill gaps within the valve aperture. Having a gap filler, coaptation element, or spacer is expected to beneficially help the systems/devices better treat functional mitral regurgitation by filling a gap in the valve. 
     In some applications, the systems/devices herein comprise an expandable gap filler, expandable coaptation element, or expandable spacer. The gap filler/coaptation element/spacer can be expandable in a variety of ways, e.g., via inflation, injection, filling, balloon-expansion, self-expansion (e.g., using a shape memory material), mechanical expansion, etc. Mechanisms of expanding the expandable gap filler/coaptation element/spacer herein can include any of the expansion mechanisms described herein, including (but not limited to) filling with a material (e.g., foam, hydrogel, or silicone), inflation, self-expansion, balloon-expansion, mechanical expansion, expanding via a stent (e.g., self-expanding, balloon, mechanical), expanding via a scissor mechanism or scissor like mechanism (e.g., with articulating joints), expanding via twisting a coil, and/or any combinations of these. 
     In some applications, systems/devices herein comprise a gap filler/coaptation element/spacer that is filled or is fillable with a material at the site of implantation, which can be done as the device is implanted or in a subsequent procedure (e.g., right after or after some time as passed, such as days, weeks, or months). Accordingly, in these applications, a material is delivered via a catheter to the device at the site of implantation and then the device is filled, injected, inflated, etc. with the material, and thus increase the size of the gap filler/coaptation element/spacer in vivo. Various materials can be utilized, such as (for example) a foam, hydrogel, or silicone. In some applications, a system/device with a gap filler/coaptation element/spacer includes a stent that encases the gap-filling portion of the device. Accordingly, a stent can be expanded at the site of implantation, which can be self-expanding (e.g., nitinol), expanded mechanically, or expanded via a balloon. The systems/devices can have a guide or guide wire that helps advance the catheter to the correct location on the gap filler/coaptation element/spacer to inject the material into the gap filler/coaptation element/spacer. 
     In some applications, a system/device with a gap filler, coaptation element, or spacer is expanded at the site of implantation utilizing mechanical expansion. For example, an expansion mechanism configured as a scissor or scissor-like mechanism (or mechanism with pivoting struts) within the gap filler/coaptation element/spacer portion could be used to cause the mechanical expansion, which can be done as the device is implanted or in a subsequent procedure. Accordingly, in these applications, the scissor or scissor-like mechanism (or mechanism with pivoting struts) can be expanded via hydraulic, pneumatic, mechanical, or magnetic means, and thus increase the size of the gap filler/coaptation element/spacer. In some applications, a catheter is delivered to the implant/device and provides a hydraulic, pneumatic, mechanical, or magnetic force to expand the expansion mechanism. In some applications, a magnetic force is applied externally of the body to expand the expansion mechanism. In some applications, a series of struts can be connected at a joint and articulate or move from a radially expanded configuration to a radially compressed configuration by the various struts articulating or moving at the joints, e.g., in a scissor-like movement. 
     In some applications, systems/devices with gap filler/coaptation element/spacer are mechanically expanded at the site of implantation utilizing a coil within the gap filler/coaptation element/spacer portion, which can be done as the device is implanted or in a subsequent procedure. Accordingly, in some applications, the circumference of the coil can be increased by twisting the coil, and thus increase the gap filler/coaptation element/spacer size. Various mean can be used to relieve tension as the coil is twisted, such as (for example) the coil contain a number of slits or furrows on the inner portion of the coil. 
     In some applications, systems/devices herein incorporate or comprise an impermeable cooptation portion and a permeable and/or open non-coaptation portion. In some applications, the impermeable coaptation portion extends into the coaptation area of the leaflet. In some applications, the impermeable coaptation portion is elongated to reach the effluent side of one or two of the opposing leaflets to help the leaflets coapt. In some applications, the impermeable coaptation portion contains or can be injected with a filler material that thickens the coaptation portion, which can help fill gaps within the valve aperture. In some applications, the impermeable coaptation portion is expanded at the site of implantation. Mechanisms of expanding the impermeable coaptation portion can include any of the expansion mechanisms described herein, including (but not limited to) filling with a material (e.g., foam, hydrogel, or silicone), inflation, self-expansion, balloon-expansion, mechanical expansion, expanding via a stent (e.g., self-expanding, balloon, mechanical), expanding via a scissor mechanism or scissor like mechanism (e.g., with articulating joints), expanding via twisting a coil, and/or any combinations of these. 
     Various implementations and applications of devices herein are to be used on any leaflet experiencing flail or prolapse. Accordingly, in some applications, a device is capable of being utilized on a leaflet of a mitral, a tricuspid, an aortic, and/or a pulmonic valve. Likewise, various implementations and applications of devices can be utilized on any area of the leaflet experiencing flail or prolapse. In some applications, a device is capable of being utilized on or near a leaflet commissure and/or any area between a leaflet&#39;s commissures. 
     To reach the site of implantation, any appropriate surgical, minimally invasive, or percutaneous technique may be utilized, including (but not limited to) a transcatheter delivery system, which can utilize a transfemoral, subclavian, transapical, transseptal, or transaortic approach. In some applications, a delivery catheter is utilized to incorporate a device, then delivered to the site of deployment via a guidewire and utilized to anchor the device at the site of implantation. 
     Some applications are directed to methods of delivering a device to the site of deployment. The various techniques, methods, operations, steps, etc. described or suggested anywhere herein (including in documents incorporated by reference herein) can be performed on a living animal (e.g., human, mammal, other animal, etc.) or on a non-living simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, tissue, etc. being simulated), etc. Accordingly, methods of delivery include both methods of treatment (e.g., treatment of human subjects) and methods of training and/or practice (e.g., utilizing an anthropomorphic phantom that mimics human vasculature to perform method). 
       FIGS.  5  and  6    provide an example depicting an implant or device  501  with a stent anchor  503  at a site of implantation. As shown here, the device is on the mitral valve  505  for illustration. In this example, one or more chordae tendineae  507  of the valve are broken resulting in leaflet flail and/or prolapse in the P2 area  509  of the posterior leaflet  511  of the valve  505 . The contact face  513  of the device  501  is situated on the influent face  515  (or atrial side) of the posterior leaflet  511  within the left atrium  517  at the site of a leaflet issues, e.g., flail, prolapse and/or rigidity. The contact face  513  can provide contact pressure onto the leaflet (e.g., a portion of the leaflet having flail, prolapse and/or rigidity) to help flatten out the leaflet (e.g., protrusion, bulge, etc. thereof) and mitigate regurgitant blood flow. 
     In some applications, the device  501  includes a coaptation portion  519  that extends beyond the edge of the posterior leaflet  511  and into the left ventricle  521 . The coaptation portion  519  can coapt with the anterior leaflet to help promote coaptation when the valve is closed. The device  501  has a cover or sheet  523  that can help provide contact pressure on the leaflet to address an issue (e.g., such as flail, prolapse, and/or rigidity) and to help coaptation of the leaflets. The coaptation portion can be configured as a wing or wing portion or be part of a wing or wing portion. 
     In some applications, the anchor  503  is a stent (e.g., a wire stent, stent with alternating struts, laser-cut stent, braided stent, balloon-expandable stent, self-expanding stent, etc.) expanded within the coronary sinus  525  adjacent to the left atrium  517 . The anchor  503  is connected to the connection point  527  (e.g., anchor receiver, etc.) of the device  501  via a connector  529  that traverses through the atrium wall  531 . Accordingly, the anchor  503  stabilizes the device  501  at the mitral valve  505 . In some applications, a different type of anchor (e.g., helical anchor, t-shaped anchor, clamp anchor, sutured anchor, etc.) can alternatively or additionally be used, e.g., an anchor could be used to anchor the device/system directly to the valve annulus or other nearby tissue. 
     In some applications, the anchor connection point or anchor receiver is configured as an interface. The interface can connect with a catheter or shaft for delivering and positioning the system/device. 
       FIGS.  7 ,  8  and  9    show examples of implants or devices (e.g., repair devices, leaflet repair devices, prolapse/flail repair devices, contact pressure devices, support devices, etc.) comprising a tether to further stabilize the device at a site of implantation. As shown here, the device is implantable at a native valve. The implant/devices can be anchored in the coronary sinus, at the annulus, onto the leaflet, and/or any other way described herein. The implant/devices can be configured to apply a contact pressure or added support to the leaflet (e.g., a portion of the leaflet, etc.). 
     In  FIG.  7   , an implant/device  701  is shown situated and implanted on a native valve  703 , depicted as a mitral valve for illustration. Extending from the coaptation portion  705  of the device  701  is a tether  707  that extends to and connects (e.g., anchors, clamps, attaches, adheres, links, etc.) to an area of ventricle wall  709 . 
     In  FIG.  8   , an implant/device  801  is situated and implanted on the native valve  803 . Extending from the coaptation portion  805  of the device  801  is a tether  807  that extends to and connects (e.g., anchors, clamps, attaches, adheres, links, etc.) to a papillary muscle  809 . 
     In  FIG.  9   , an implant/device  901  is situated and implanted on the native valve  903 . Extending from the coaptation portion  905  of the device  901  is a tether  907  that extends to and connects (e.g., anchors, clamps, attaches, adheres, links, etc.) to the apex  909  of the ventricle. 
       FIGS.  10 A,  10 B, and  10 C  show examples of implants or devices (e.g., repair devices, leaflet repair devices, prolapse/flail repair devices, contact pressure devices, support devices, etc.) situated in various different sites of implantation along the posterior leaflet of the mitral valve. The implant/devices can be configured to apply a contact pressure or added support to the leaflet (e.g., a portion of the leaflet, etc.). 
     In  FIG.  10 A , an implant/device  1001  is situated and implanted on top of the cleft between P2  1003  and P3  1005  of the posterior leaflet. The device can be anchored in a variety of ways. In some applications, the device  1001  is anchored within the coronary sinus. In some applications, the device  1001  is anchored to the annulus. 
     In  FIG.  10 B , an implant/device  1011  is situated and implanted on top of the commissure between the posterior leaflet  1013  and the anterior leaflet (not shown). The device can be anchored in a variety of ways. In some applications, the device  1011  is anchored within the coronary sinus. In some applications, the device  1011  is anchored to the annulus. 
     In  FIG.  10 C , an implant/device  1021  is configured to span across much of the posterior leaflet  1023 , including covering parts of P1, all of P2, and parts of P3. The device can be anchored in a variety of ways. In some applications, the device  1021  is anchored within the coronary sinus. In some applications, the device  1021  is anchored to the annulus. 
     Although examples of implantation sites are depicted along the posterior leaflet of the mitral valve, it should be understood that various implementations and applications can be utilized on other leaflets or within other valves. 
       FIGS.  11  and  12    show an example implant or device  1101  (e.g., a repair device, a leaflet repair device, a prolapse/flail repair device, contact pressure device, support device, etc.) with an anchor. The implant/device can be anchored in a variety of ways. In some applications, the implant/device  1101  is anchorable within the coronary sinus. In some applications, the implant/device is anchorable to a valve annulus at a site of implantation, e.g., as shown in  FIG.  12   . The implant/devices can be configured to apply a contact pressure or added support to the leaflet (e.g., a portion of the leaflet, etc.). 
     As shown in  FIGS.  11  and  12   , the device is implantable at a native valve  1103  (e.g., a mitral valve, tricuspid valve, etc.). The contact face of the device  1101  is situated on the influent face  1105  (or atrial side) of a native leaflet  1107  (shown as a posterior leaflet) within the atrium  1109  at the site of flail, prolapse, rigidity, and/or other leaflet abnormality. The contact face can provide contact pressure and/or support onto the flail, prolapse, rigidity, etc. to help flatten out and/or reshape the bulge, protrusion, flail, etc. and mitigate regurgitant blood flow. The device  1101  includes a coaptation portion  1111 . The coaptation portion  1111  can be configured to cover some or all of the native leaflet. In some applications, the coaptation portion  1111  is configured to extend beyond a lower edge of the native leaflet  1107 . The coaptation portion can be configured as a wing or wing portion or be part of a wing or wing portion. 
     In some applications, the device  1101  has a covering that spans the contact face and can help provide contact pressure and/or support on the flail, prolapse, rigidity, leaflet abnormality, etc. and can help coaptation. In some applications, the covering is mesh sheet. In some applications, the covering is one or more of a fabric sheet, polymer sheet, pericardium sheet, etc. The contact face and/or covering can be configured to allow blood and plasma to flow therethrough such that pressure from blood does not disrupt, deflect, or dislodge the device. A mesh covering can be particularly useful to allow blood and plasma to flow therethrough without disrupting device function. 
     In some applications, the device  1101  includes an optional support  1113  (e.g., a counterforce support, atrial support, etc.). The support  1113  can be configured to press or abut against a wall of the heart (e.g., the wall of atrium  1109 ) to help orient and/or maintain the position of the device, which can help the device provide contact pressure and/or support on a native leaflet (e.g., to mitigate or eliminate flail, prolapse, rigidity issues, and/or other leaflet abnormalities). The support  1113  can also be configured to help prevent the contact face and/or a cover thereon from flailing or otherwise moving back into or toward the atrium in an undesired way. For some applications, and as shown, support  1113  comprises (e.g., consists essentially of) a wire loop. 
     In some applications, the device  1101  further includes an anchor  1115  that anchors the device  1101  to the valve annulus  1117 . The anchor can be the same as or similar to any other anchors or anchoring mechanisms described herein. In some applications, the anchor  1115  is a helical anchor (e.g., as shown in  FIG.  12   ) that can be screwed or rotated into tissue. A helical anchor rotated into annulus tissue can be particularly good at anchoring and holding the device at the native valve, as the annulus tissue is strong and helical designs allows for plenty of contact surface and engagement with the tissue. 
       FIG.  13    shows an example implant or device  1301  (e.g., repair device, leaflet repair device, prosthetic device, contact pressure device, support device, etc.) comprising a stent anchor (not shown) at a site of implantation that is further clamped onto a leaflet of a native valve  1303 . In some applications, as shown here, the device is implantable at the mitral valve. The contact face of the device  1301  is situated on the influent face  1305  (or atrial side) of the native leaflet  1307  (e.g., a posterior leaflet, etc.) within the atrium  1309  at the site of flail, prolapse, rigidity issue, and/or other leaflet abnormality. The contact face can provide contact pressure and/or support onto the flail, prolapse, etc. to help flatten out and/or reshape the leaflet (e.g., a protrusion, bulge, etc.) and mitigate or eliminate regurgitant blood flow. The device  1301  includes a coaptation portion  1311 . The coaptation portion can be configured to extends to the edge of the leaflet  1307 . A clamp  1313  can be attached at the edge of the leaflet to help secure the coaptation portion  1311  and/or the contact face to the leaflet  1307  edge. The clamp  1313  secures the device  1301  to the posterior leaflet  1307 , which allows the device  1301  to move with the posterior leaflet  1307  as it opens and closes. 
     In some applications, the device  1301  has a covering  1315 . The covering  1315  can be the same as or similar to other coverings described herein. In some applications, the covering spans the contact face and can help provide contact pressure on the flail, prolapse, rigidity, etc. and can help coaptation. 
       FIGS.  14  and  15    show an example system or implant/device with a gap filler/coaptation element/spacer  1401  and an anchor. The anchor can be the same as or similar to other anchors described herein. In some applications, the system/device comprises a stent anchor  1403  at a site of implantation and/or within a blood vessel of the heart (e.g., coronary sinus, etc.). As shown here, the gap filler/coaptation element/spacer is implantable at a native valve  1405 , e.g., a mitral valve, a tricuspid valve, etc. In some applications, the gap filler/coaptation element/spacer  1401  is a bulky substance capable of filing in gaps that may occur at the leaflet coaptation area  1407  when the native valve  1405  is closed. In some applications, the anchor  1403  is a stent expanded within a blood vessel, such as the coronary sinus  1409  adjacent to the left atrium  1411 . In some applications, the anchor  1403  is connected to the connection point  1413  of the gap filler/coaptation element/spacer  1401  via a connector  1415  that traverses through the atrium wall  1417 . Accordingly, the anchor  1403  stabilizes the gap filler/coaptation element/spacer  1401  at the native valve  1405 . 
       FIGS.  16 A and  16 B  an example of an expandable stent anchor  1601  with a connector  1603 . The anchor  1601  can be expanded within vasculature (e.g., coronary sinus, circumflex artery, etc.) to the walls  1605  of the vasculature. The connector  1603  (e.g., tether, suture, line, wire, etc.) can extend from the anchor  1601  and traverse through the vasculature wall  1605  connecting or coupling an implanted device to the anchor such that the implanted device is secured, e.g., via tensile forces. 
       FIGS.  16 C and  16 D  show an example anchor  1611  with a connector  1613  (e.g., tether, suture, line, wire, etc.). The anchor  1611  can be situated proximate to the walls  1615  of the vasculature. The connector  1613  can extend from the anchor  1611  and traverse through the vasculature wall  1615  connecting or coupling the anchor to implanted device to secure the implanted device, e.g., by creating a tensile force between the anchor  1611  and the implanted device that secures the anchor  1611  and device in place. 
       FIGS.  17 A,  17 B, and  17 C  each illustrate an example of an anchor capable of being secured (e.g., embedded, lodged, screwed, etc.) into native tissue.  FIG.  17 A  illustrates an example of a curved or looped anchor  1701  with an upper portion  1703  and lower portion  1705  and a central loop  1707 . The upper and lower portions  1703  and  1705  can embed with the tissue and the central loop  1707  can interlink with a device to secure it to the tissue at the site of implantation. 
       FIG.  17 B  illustrates an example of an anchor  1711  with two distal ends  1713  and  1715  and an inner ridge  1717 . The two distal ends  1713  and  1715  can embed with the tissue and the inner ridge  1717  can interlink with a device to secure it to the tissue at the site of implantation. 
       FIG.  17 C  illustrates an example of a helical anchor  1721  capable of screwing or rotating into tissue at the lower end  1723  and attaching to a device at its upper end  1725  to secure the device to the tissue at the site of implantation. 
       FIGS.  17 D and  17 E  illustrate an example of a T-anchor  1731  capable of anchoring within a crevice within the heart valve (e.g., in a cleft and/or commissure). The T-anchor  1731  includes two arms  1733  and  1735  and a connecting portion  1737 . As the T-anchor  1731  is being deployed into a crevice, the two arms  1733  and  1735  can remain in a contracted position (see  FIG.  17 D ). To secure the anchor  1731 , the two arms  1733  and  1735  can expand outward within a crevice and under the leaflet such that it can secured within the crevice (see  FIG.  17 E ). The connecting portion  1737  connects the anchor to an implant or device. 
       FIGS.  18 A and  18 B  illustrate cross-sectional views of an example of a dual helix anchor in its housing. In some applications, the housing is the anchor head. The anchor  1801  includes two helixes or helical anchor portions  1803  and  1805  that, in a first configuration, are stacked, nested, or arranged within a tubular compartment or housing  1807 . The two helixes/anchor portions  1803  and  1805  can be configured to transition to a second configuration in which the helixes/anchor portions extend from the housing  1807  askew or at different angles from each other (see  FIG.  18 B ). The two helixes or helical anchor portions  1803  and  1805  can be configured to extend out of the housing  1807  in different directions or at different angles as the helixes/anchor portions are pushed or rotated out  1809  of the tubular compartment/housing  1807 . The helixes or helical anchor portions  1803  and  1805  can beneficially be extended from the housing different amounts or lengths depending on the anatomy of the patient and/or other factors. For example, in some circumstances, the user may want to extend the helixes/anchor portions more (or so a greater length extends from the housing) to increase depth of penetration and strength of retention, and in other circumstances, the user may want to extend the helixes/anchor portions less (or so a shorter length extends from the housing) to avoid damaging a blood vessel of the heart, etc. 
       FIGS.  18 C and  18 D  illustrate cross-sectional views of an example of a low-profile dual helix anchor that is compressed or compressible within its housing. The anchor  1811  includes two spring-like compressible helixes or helical anchor portions  1813  and  1815  that, in a first configuration, are stacked, nested, or arranged within a tubular compartment or housing  1817 . In the first configuration, the two helixes/anchor portions  1813  and  1815  are compressed (e.g., axially compressed to a smaller height) within the tubular compartment/housing  1817 . The helixes/anchor portions  1813  and  1815  are configured to decompress or axially extend as they extend or are pushed or rotated out from the compartment/housing. The two helixes/anchor portions  1813  and  1815  can be configured to transition to a second configuration in which the helixes/anchor portions extend from the housing  1817  askew or at different angles from each other (see  FIG.  18 D ). The two helixes/anchor portions  1813  and  1815  can be configured to extend out of the housing  1817  in different directions or at different angles as the helixes/anchor portions are pushed or rotated out of the tubular compartment/housing  1817 . The anchors or anchor portions  1813  and  1815  can beneficially be extended from the housing different amounts or lengths depending on the anatomy of the patient and/or other factors, e.g., as discussed above with respect to anchor  1801 . 
       FIGS.  18 E and  18 F  provide cross-sectional views of an example of a low-profile dual helix anchor that is compressed or compressible within its housing. The anchor  1821  includes an inner  1823  spring-like compressible helix or helical anchor portion and an outer  1825  spring-like compressible helix or helical anchor portion, that in a first configuration, are stacked, nested, or arranged together within a tubular compartment or housing  1827  with the inner helix/anchor portion  1823  radially inside the outer helix/anchor portion  1825  (e.g., the inner helix/anchor portion  1823  can have a smaller diameter than the outer helix/anchor portion  1825 ). In the first configuration, the inner and outer helixes/anchor portions  1823  and  1825  are compressed (e.g., axially compressed to a smaller height) within the tubular compartment/housing  1827 . The helixes/anchor portions  1823  and  1825  are configured to decompress or axially extend as they extend or are pushed or rotated out from the compartment/housing. The inner and outer helixes/anchor portions  1823  and  1825  can be configured to transition to a second configuration in which the helixes/anchor portions extend from the housing  1827  askew or at different angles from each other (see  FIG.  18 F ). The inner and outer helixes/anchor portions  1823  and  1825  can be configured to extend out of the housing  1827  in different directions or at different angles as the helixes/anchor portions are pushed or rotated out of the tubular compartment/housing  1827 . The anchors or anchor portions  1823  and  1825  can beneficially be extended from the housing different amounts or lengths depending on the anatomy of the patient and/or other factors, e.g., as discussed above with respect to anchors  1801  and  1811 . 
       FIGS.  18 G and  18 H  provide cross-sectional views of an example of a low-profile single helix anchor that is compressed and coiled within its housing. The anchor  1831  includes a single spring-like compressible helical anchor or anchor portion  1833  that, in a first configuration, is coiled within a tubular compartment/housing  1835 . In the first configuration, the helical anchor/anchor portion  1833  is compressed within the tubular compartment/housing  1835 . The anchor/anchor portion  1833  is configured to decompress or axially extend as it extends or is pushed/rotated out from the compartment/housing. The anchor/anchor portion  1833  can thereby transition to a second configuration in which the anchor/anchor portion extends from the housing  1837 . In some applications, the anchor/anchor portion  1833  is arranged in the housing such that each turn or loop of the coil has the same or a similar diameter, such that each turn/loop of the coil is stacked on top of an adjacent turn/loop of the coil until the end, e.g., in the form of a helix. In some applications, and as shown, the anchor/anchor portion  1833  is arranged or configured such that, in the housing, the helical anchor/anchor portion is in a single plane (e.g., with a large outer turn/loop of the coil and each subsequent turn/loop of the coil having a slightly smaller diameter radially inside an adjacent larger diameter turn/loop), e.g., in the form of a planar spiral. 
       FIG.  19 A  illustrates a cross-sectional view an example of a system with an anchor  1901  and implant/device  1903  with an adjustable contact-face angle. There are multiple potential mechanisms that could be used to adjust the contact-face angle of the implant/device as it is being anchored into tissue. In some applications, the implant/device  1903  incorporates a fulcrum  1905  that is connected to the anchor housing  1907 . A deployment tool  1909  is utilized to anchor the anchor into tissue. In some applications, the deployment tool  1909  includes a cable  1911  that extends to the front of the device  1903 . The cable  1911  in conjunction with the fulcrum  1905  can adjust the contact-face angle of the implant/device  1903  to match the angle of the native tissue. Once matched, the deployment tool  1909  can anchor the anchor  1901  into the native tissue. The anchor  1901  is shown as a helical anchor, but other anchor configurations are also possible. 
       FIGS.  19 B and  19 C  illustrate a cross-sectional view of an example of an anchor  1921  and an implant/device  1923  with an adjustable contact-face angle. This example portrays one mechanism to adjust the contact-face angle of the device as it is being anchored into tissue. The implant/device  1923  incorporates two sliding mechanisms  1925  and  1927  on respective sides (e.g., opposite sides) of the anchor housing  1929 . A deployment tool  1931  is utilized to anchor the helical anchor into tissue. The sliding mechanisms  1925  and  1927  can adjust the contact-face angle of the implant/device  1923  to match the angle of the native tissue. Once matched, the deployment tool  1931  can anchor the helical anchor  1921  into the native tissue. The anchor  1921  is shown as a helical anchor, but other anchor configurations are also possible. 
       FIG.  20 A  illustrates an example depicting an implant/device  2001  (e.g., repair device, leaflet repair device, prosthetic device, contact pressure device, support device, etc.) comprises a wire form for providing contact pressure and/or support to a leaflet. The implant/device  2001  includes a contact face formed by undulating wire  2003  capable of providing contact pressure on and/or support to a leaflet (e.g., to address flail, prolapse, rigidity, and/or other leaflet abnormalities). The implant/device  2001  includes a coaptation portion  2005  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The implant/device  2001  includes a connector  2007  that can connect with an anchor. In some applications, the implant/device  2001  can optionally include a permeable, semipermeable, or impermeable cover or sheet (not shown) that can help provide contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or leaflet abnormality. Optionally, the cover or sheet can be a mesh sheet or mesh covering (not shown). 
       FIG.  20 B  illustrates an example implant or device  2011  (e.g., repair device, leaflet repair device, prosthetic device, contact pressure device, support device, etc.) comprising a wire form for providing contact pressure and/or support to a leaflet. The implant/device  2001  includes a contact face formed by three sectional wireforms  2013 ,  2015 , and  2017  that intersect or overlap one another and are capable of providing contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or leaflet abnormality. The three sectional wireforms  2013 ,  2015 , and  2017  can expand or contract  2019  laterally (e.g., fanning outwards to various degrees) to adapt to the specifics of the native leaflet flail, prolapse, rigidity, and/or leaflet abnormality. The implant/device  2011  includes a coaptation portion  2021  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The implant/device  2001  includes a connector or connection point  2023  that can connect with an anchor. In some applications, the implant/device  2001  can optionally include a permeable, semipermeable, or impermeable cover or sheet (not shown) that can help provide contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or leaflet abnormality. Optionally, the cover/sheet can be a mesh sheet or cover (not shown). The connector or connection point can comprise an anchor receiver and/or an interface. 
       FIGS.  21 A and  21 B  illustrates an example implant or device  2101  (e.g., repair device, leaflet repair device, prosthetic device, contact pressure device, support device, etc.) comprising a wire form for providing contact pressure and/or support to a leaflet. The implant/device  2101  includes a contact face  2103  capable of providing contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or abnormality. The implant/device  2001  includes a coaptation portion  2105  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The device  2001  includes an anchor connection point  2107  that can connect with an anchor. The anchor connection point can comprise an anchor receiver. In some applications, the anchor connection point or anchor receiver comprises or is configured as an interface. The interface can connect with a catheter or shaft for delivering and positioning the system/device and can be the same as or similar to other interfaces herein. The portion extending below the anchor connection point can be considered a wing or wing portion that comprises the contact face  2103  and coaptation portion  2105 . The implant or device  2101  can be configured to be anchored in any of the ways described herein to any of the locations described herein, e.g., to the annulus, in a coronary vessel, etc. 
     In some applications, the coaptation portion  2105  can include an optional clip, fastener, or other anchor mechanism to be attached or clamped onto a leaflet edge, which may allow the device  2101  to move with the leaflet as it opens and closes. 
     In some applications, the device includes an optional counterforce support  2109  that can press against an atrium wall to help the device provide contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. 
     In some applications, the device  2001  (e.g., the wing portion of the device) includes a permeable non-coaptation portion  2111 , which can made of mesh or otherwise include openings, to provide contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality and includes an impermeable coaptation portion  2113  that can help promote coaptation. It is noted that various examples can include an elongated impermeable coaptation portion  2113  capable of reaching the effluent side (or ventricular side) of one or two opposing native leaflets to help valve closure. In various examples, the impermeable coaptation portion  2113  is thickened such that it can fill gaps within the valve aperture, e.g., serving as a gap filler/coaptation element/spacer. In some applications, coaptation portion  2113  can be filled and/or expanded at the site of implantation. 
     In some applications, as shown in  FIG.  21 A , the device  2001  (e.g., the wing portion of the device) includes an open or uncovered area between the permeable non-coaptation portion  2111  and the anchor connection point  2107 . In some applications, this open or uncovered area allows blood to freely flow therethrough and will not have any tissue ingrowth, which can help prevent the blood from moving the device in an undesired way. In some applications, the permeable non-coaptation portion  2111  can be omitted leaving this entire area (e.g., the area between the impermeable coaptation portion  2113  and the anchor connection point  2107 ) open with blood able to flow therethrough. The frame and coaptation portion  2113  provide the contract pressure, while the open or uncovered area allows blood flow and avoids undue pressure on the device, and avoids tissue ingrowth in the uncovered region. The frame of the device can be of a variety of sizes and shapes (including any of the other frame shapes, sizes, configurations described herein or depicted in the figures with respect to any example, and can include one or multiple anchor connection points and/or interfaces), e.g., tear drop, oval, ovoid, triangular, etc. The open or uncovered area, permeable non-coaptation portion  2111  (if included), and impermeable coaptation portion  2113  can be of various sizes and shapes beyond those depicted in  FIG.  21 A  For example, the device can include an impermeable coaptation portion  2113  that covers between 20%-80% of the area inside the frame, while having an open portion that accounts for between 10%-80% of the area inside the frame, and/or optionally having a permeable non-coaptation portion that accounts for between 10%-80% of the area inside the frame. In some applications, the device  2001  includes an impermeable coaptation portion  2113  that covers between 40%-70% of the area inside the frame and an open/uncovered portion in 30%-60% of the area inside the frame. In some applications, the impermeable coaptation portion  2113  may be omitted, while a permeable portion  2111  (which could then be used in the coaptation region) and an open/uncovered portion are used, and can be arranged or designed similarly to the above. 
       FIGS.  22 A and  22 B  illustrate an example implant or device  2201  (e.g., repair device, leaflet repair device, prosthetic device, contact pressure device, support device, etc.) comprising a wireform. The device  2201  includes a contact face  2203  capable of providing contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or abnormality. The device  2201  includes a coaptation portion  2205  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The coaptation portion  2205  can be clamped onto a leaflet edge, which will allow the device  2201  to move with the leaflet as it opens and closes. The device  2201  includes an anchor connection point  2207  (which can comprise an anchor receiver) capable of connecting to anchor. In some applications, the device  2201  includes a permeable, semipermeable, or impermeable cover or sheet  2209  that can help provide contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or abnormality. Optionally, the cover or sheet can be a mesh sheet or mesh cover (such as shown in  FIG.  22 C ). 
       FIG.  23 A  illustrates an example implant or device  2301  comprising a wire form for providing contact pressure and/or support to a leaflet. The device  2301  includes a contact face capable of providing contact pressure and/or support on a leaflet flail, prolapse, rigidity, and/or abnormality. The device  2301  includes a coaptation portion  2303  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The coaptation portion  2303  includes an internal portion devoid of wire form  2305  such that various procedures can be performed on the native leaflet coaptation area. The device  2301  includes an anchor connection point  2307  (which can comprise an anchor receiver) that can connect with an anchor, e.g., any of the various anchors described herein. In some applications, the device includes an optional counterforce support  2309  that can press against an atrium wall to help the device provide contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. In some applications, the device  2301  includes a permeable mesh  2311  that can help provide contact pressure and/or support on a leaflet issue, e.g., flail, prolapse, rigidity, etc. In some applications, the anchor connection point or anchor receiver comprises or is configured as an interface. The interface can connect with a catheter or shaft for delivering and positioning the system/device. The portion extending below the anchor connection portion or interface can be considered a wing or wing portion that comprises the coaptation portion, etc. 
     Illustrated in  FIG.  23 B  is an example implant or device  2301  comprising a wire form for providing contact pressure and/or support to a leaflet. The example depicted in  FIG.  23 B  is the same as the example of  FIG.  23 A  with an added anchor receiver at the interface or anchor connection point, which can be configured as a housing or tubular compartment  2313 , for housing and/or connecting a helical anchor to the implant/device. For some applications, the anchor receiver or housing or tubular compartment  2313  is connected with the implant/device  2301  at the interface or anchor connection point  2307 .  FIG.  23 C  is an enlarged cross-sectional view of the housing/tubular compartment  2313  and the wire form of the anchor connection point  2307  intersecting therethrough. The anchor connection point wire form  2307  passes through guide tubes  2315  (e.g., defined by housing  2313 ), securing the housing/tubular compartment  2313  to the device  2301 . The housing/tubular compartment  2313  includes an aperture  2317  for which a helical anchor  2319  can pass through, as shown in  FIG.  23 D . Guide tubes  2315  and/or wire form  2307  may serve as cross-bars that traverse aperture  2317 . The helical anchor  2319  anchors the housing/tubular compartment  2313  and thus the implant/device  2301  to a secure portion of tissue (e.g., the annulus) at the site of deployment. In some applications, this is achieved by helical anchor  2319  (i.e., a helical tissue-engaging element of the anchor) being screwed around and over a cross-bar that traverses aperture  2317  (e.g., guide tube  2315 , wire form, and/or another cross-bar element defined by housing  2313 ), and into the tissue until a head of the anchor abuts the cross-bar. The housing/tubular compartment  2313  is depicted with a rounded groove  2321  that can precisely engage with a tool (e.g., cloaked screwdriver, anchor driver, etc.) with a complementary round protrusion. 
     Methods of delivering implant/device  2301  and other implants/devices herein (e.g., implant/device  2421 , etc.) can include advancing a delivery catheter transvascularly (e.g., via a transfemoral, a subclavian, a transapical, a transseptal, or a transaortic approach) to the native heart valve, advancing the anchor (which can be the same as or similar to any anchors or securing features described herein) from the delivery catheter into tissue of the heart, thereby anchoring the implant/device to the tissue, and releasing the implant/device from the delivery catheter, such that the implant/device extends along a portion of a leaflet of the native heart valve. Advancing the anchor from the delivery catheter into tissue of the heart and releasing the leaflet repair implant from the delivery catheter can be done in either order. 
     Where the anchor is a helical anchor, advancing the anchor can include rotating the helical anchor into the tissue (e.g., into the annulus or a wall of the heart). 
     The implant/device can transition from a compressed delivery configuration inside the delivery catheter (for a smaller delivery profile) to an expanded configuration outside of the delivery catheter to better cover the leaflet or problem portion of the leaflet. 
     This method can be performed on a living animal or on a simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, heart, tissue, etc. being simulated), etc. 
       FIG.  24 A  illustrates an example implant or device  2401  comprising a wire form with swing hinge to adjust the contact-face angle. The device  2401  includes a contact face capable of providing contact pressure on and/or support to a leaflet, e.g., to address leaflet flail, prolapse, rigidity, and/or abnormality. The device  2401  includes a coaptation portion  2403 , an optional counterforce support  2405 , and a permeable mesh  2407 . The device  2401  further includes a swing hinge  2409  that connects the device  2401  with a W-shaped anchor  2411 . The swing hinge  2409  can adjust the angle of the W-shaped anchor  2411  with reference to the contact-face angle of the device  2401  to match the angle of the native tissue. A detailed close-up image of the hinge is provided in  FIG.  24 B . 
       FIG.  24 C  illustrates an example implant or device  2421  comprising a wire form with a soft compliable hinge to adjust the contact-face angle. The device  2421  includes a contact face capable of providing contact pressure on and/or support to a leaflet, e.g., to address leaflet flail, prolapse, rigidity, and/or other issues. The device  2421  includes a coaptation portion  2423  and a permeable mesh  2425 . The device  2421  further includes an interface or hinge  2427  made of soft pliable material (e.g., PTFE) that allows a helical anchor to anchor the device  2421  to tissue. The pliability of the soft hinge  2427  adjusts allows the contact-face angle of the device  2421  to match the angle of the native tissue regardless of the deployment angle of the helical anchor. A detailed close-up image of the hinge is provided in  FIG.  24 D . The portion extending below the interface or hinge can be considered a wing or wing portion. 
       FIGS.  25  and  26    illustrates an example implant or device  2501  comprising a wire form with a gap filler, coaptation element, or spacer  2503 .  FIG.  26    is a cross-sectional view of the device  2501  provided in  FIG.  25   . The device  2501  includes a sheet  2505  surrounding the wire form  2507  and a coaptation element, spacer, or filler  2503 . The device also includes a contact face  2503  capable of providing contact pressure on and/or support to a leaflet, e.g., to address leaflet flail, prolapse, rigidity, and/or other issues. The device  2501  includes a coaptation portion  2509  that can extend into the coaptation area of a leaflet and help promote coaptation between leaflets. The gap filler/coaptation element/spacer  2503  expands the thickness within the coaptation portion  2509  such that the coaptation portion  2509  can fill a gap within the coaptation area of a valve to help it close and/or prevent or inhibit valvular regurgitation. The device  2501  includes an anchor connection point  2511  that can connect with an anchor via a connector or an anchor receiver. A permeable, semipermeable, impermeable, or mesh sheet can be utilized. The coaptation element or spacer  2503  can comprise a material (e.g., shape memory material, foam, etc.) or a mechanism to expand the device, e.g., via balloon expansion, self-expansion, mechanical expansion, etc. For instance, the coaptation element or spacer  2503  can comprise a foam, a hydrogel, or a silicone material. Optionally, the coaptation element or spacer  2503  can comprise a scissor mechanism or an expandable coil. Furthermore, the device can include an expandable stent within or on top of the sheet  2505 . The anchor connection point can comprise an interface, which can be the same as or similar to other interfaces herein. 
       FIG.  27    illustrates an example implant or device  2701  comprising a wire form with small anchors configured as hooks  2703  capable of hooking into a crevice with a valve (e.g., cleft or commissure). The device  2701  includes a sheet  2705  that extends between the hooks  2703  that is capable of applying contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. The sheet can be permeable, semipermeable, impermeable, or a mesh. The device  2701  includes an anchor connector  2707  capable of connecting to an additional anchor, but can optionally utilize an anchor connection point as described for  FIG.  20   . The anchor connector or anchor connection point can comprise an interface, which can be the same as or similar to other interfaces herein. 
       FIG.  28    illustrates an example implant or device  2801  comprising a wire form with indentations  2803  capable of securing within a crevice with a valve (e.g., cleft or commissure). The device  2801  includes a sheet  2805  that extends between the indentations  2803  that is capable of applying contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. The sheet can be permeable, semipermeable, impermeable, or a mesh. The device  2801  includes an anchor connector  2807  capable of connecting to an anchor, but can optionally utilize an anchor connection point as described for  FIG.  20   . The anchor connector or anchor connection point can comprise an interface, which can be the same as or similar to other interfaces herein. 
       FIG.  29    illustrates an example implant or device  2901  comprising a wire form with a static portion  2903  and a dynamic portion  2905 . The static portion  2903  is utilized to situate and secure the device  2901  and include indentations  2907  capable of securing within a crevice with a valve (e.g., cleft or commissure). The dynamic portion  2905  is capable of being adjusted such that it can be situated onto a leaflet flail, prolapse, rigidity, and/or abnormality. The dynamic portion  2905  incorporates a sheet  2909  that is capable of applying contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. The sheet can be permeable, semipermeable, impermeable, or a mesh. The device  2901  includes an anchor connector  2911  capable of connecting to anchor, but can optionally utilize an anchor connection point as described for  FIG.  20   . The anchor connector or anchor connection point can comprise an interface, which can be the same as or similar to other interfaces herein. 
       FIG.  30    illustrates an example implant or device  3001  comprising a wire form with a static portion  3003  and a dynamic portion  3005 . The static portion  3003  is utilized to situate and secure the device  3001  and include indentations  3007  capable of securing within a crevice with a valve (e.g., cleft or commissure). The dynamic portion  3005  is capable of being adjusted such that widened or elongated, situating onto a leaflet flail, prolapse, rigidity, and/or abnormality. The dynamic portion  3005  incorporates a sheet  3009  that is capable of applying contact pressure on and/or support to a leaflet flail, prolapse, rigidity, and/or abnormality. The sheet can be permeable, semipermeable, impermeable, or a mesh. The device  3001  includes an anchor connector  3011  capable of connecting to anchor, but can optionally utilize an anchor connection point as described for  FIG.  20   . The anchor connector or anchor connection point can comprise an interface, which can be the same as or similar to other interfaces herein. 
       FIGS.  31 A- 31 L  are schematic views of example steps that can be used in delivering an implant or prosthetic device to a mitral valve and secure the implant with an anchor located in the coronary sinus, utilizing a connector to that traverse through a wall of the coronary sinus and left atrium. To help understand the delivery process, several figures provide a traverse-plane view within the left atrium superior to the mitral valve and several other figures provide a coronal-plane view within the left chambers sectioning through the coaptation area of the mitral valve. While described with respect to the coronary sinus and mitral valve, the system, devices, methods, steps, etc. can be equally applied to other vasculature of the heart and other valves mutatis mutandis. 
       FIG.  31 A  shows a guidewire  3101  being advanced from the right atrium into the coronary sinus through its ostium or opening. A puncture catheter  3103  is then advanced over the guidewire  3101 , as seen in  FIG.  31 B . The puncture catheter  3103  is introduced into the body through a proximal end of an introducer sheath (not shown). An introducer sheath provides access to the particular vascular pathway (e.g., jugular or subclavian vein) and may have a hemostatic valve therein. While holding the introducer sheath at a fixed location, the puncture catheter  3103  is directed to a site of the coronary sinus/left atrium wall to traverse. 
     At least a distal end of the puncture catheter  3103  preferably has a slight curvature built therein, with a radially inner and a radially outer side, so as to conform to the curved coronary sinus. An expandable anchoring member  3105  is exposed along a radially outer side of the catheter  3103  adjacent a distal segment  3107  that may be thinner than or tapered narrower from the proximal extent of the catheter. Radiopaque markers  3109  on the catheter  3103  help determine the precise advancement distance for desired placement of the anchoring member  3105  within the coronary sinus. 
       FIG.  31 C  shows radially outward deployment of the expandable anchoring member  3105 , which in the illustrated example as a bulbous balloon but could also be a braided mesh. One advantage of a mesh is that it avoids excessive blockage of blood flow through the coronary sinus during the procedure. Other possible anchoring structures include (but are not limited to) nitinol wire form stent like structures. Expansion of the anchoring member  3105  presses the radially inner curve of the catheter against the luminal wall of the coronary sinus. The expandable anchoring member  3105  is located adjacent the distal segment  3107  of the puncture catheter  3103 , and expands opposite a needle port  3111  formed in the radially inner side wall of the catheter. The needle port  3111  abuts the luminal wall and faces toward a tissue wall  3113  between the coronary sinus and the left atrium. The catheter  3103  is advanced so that the needle port  3111  is properly located at the appropriate site to traverse the tissue wall  3113 , which can be guided by visualizing the radiopaque markers  3109 . For instance, the needle port  3111  can be located approximately above the P2 segment of the posterior leaflet of the mitral valve as shown. The anchoring member  3105  may be centered diametrically across the catheter  3103  from the needle port  3111 , or as shown may be slightly offset in a proximal direction from the needle port  3111  to improve leverage. 
     The curvature at the distal end of the puncture catheter  3103  aligns proximal to the anatomy within the coronary sinus and orients the needle port  3111  inward, while the anchoring member  3105  holds the catheter  3103  in place relative to the coronary sinus. Subsequently, as seen in  FIG.  31 D , a puncture sheath  3115  having a puncture needle  3117  with a sharp tip advances along the catheter  3103  such that it exits the needle port  3111  at an angle from the longitudinal direction of the catheter and punctures through the wall  3113  into the left atrium. The anchoring member  3105  provides rigidity to the system and holds the needle port  3111  against the wall  3113 . The puncture needle  3117  is retracted from within the puncture sheath  3115  and is removed completely from the catheter  3103 . 
       FIGS.  31 E and  31 F  then show advancement of a second guidewire  3119  through the puncture sheath  3115  lumen, crossing through the left atrium the mitral valve aperture and into the left ventricle.  FIG.  31 F  further illustrates removal of the puncture sheath  3115  from the left atrium and into the puncture catheter  3103 , which leaves just the guidewire  3119  extending through the coronary sinus and into the left chambers. During these steps, the anchoring member  3105  remains expanded against the opposite luminal wall of the coronary sinus for stability, but is subsequently removed along with the puncture catheter  3103  to allow a delivery catheter  3121  to enter into the left chambers. 
       FIGS.  31 G and  31 H  show a delivery catheter  3121  advanced along the guidewire  3119  and through the tissue wall  3113  into the left atrium. Within the delivery catheter  3121  is a compressed device  3123  that is to be implanted within the left chambers and onto a flail, flail, prolapse, rigidity, and/or other abnormality of the P2 segment of the posterior leaflet. 
       FIG.  31 I  then shows advancement of the device  3123  into the left chambers and the simultaneous retraction of the delivery catheter  3121  back through the atrium tissue wall  3113 . As the device  3123  advances, it expands into form.  FIG.  31 J  shows a fully expanded device  3123  at the site of implantation, which is the P2 segment of the posterior leaflet.  FIGS.  31 J and  31 K  show a connector  3125  of the device  3123  is released as the delivery catheter  3121  retracts back through the tissue wall  3113  into the coronary sinus such that the connector traverses the tissue wall  3113 . The connector  3125  connects the expanded and released device  3123  with a condensed wire stent anchor  3127  still within the delivery catheter  3121 . 
       FIGS.  31 K and  31 L  shows further retraction of the delivery catheter  3121 , which results in the advancement and release of the wire stent anchor  3127  that expands and anchors within the coronary sinus. Subsequently, the entire delivery catheter  3121  is removed along the guidewire  3119  from the body, which is then removed from the body. The delivery process results in the device  3123  implanted onto the P2 segment of the mitral valve&#39;s posterior leaflet that is anchored utilizing a wire stent anchor  3127  expanded within the coronary sinus. 
     Some examples herein are directed towards compressive devices (e.g., compressive stents, compressive clamps, compressive splints, compressive forms, etc.) for mitigating heart valve leaflet flail, prolapse, rigidity, and/or other abnormalities. In some applications, a compressive device is capable of clamping onto a leaflet, holding onto its place on the leaflet while providing compressive and contact pressure onto a region of flail, prolapse, rigidity, and/or abnormality. The compressive and contact pressure provided by various stent implementations helps flatten out and/or reshape the flail, prolapse, rigidity, and/or abnormality, which helps extend the coapting edge of a leaflet back towards the coaptation area when in a closed position. Proper coaptation that results in a fully closed valve prevents valve regurgitation. 
     In some applications, a compressive device has an effluent portion and an influent portion that compress together via compression forces. When attached onto the leaflet, the effluent portion sits on the effluent face of the leaflet and the influent portion sits on the influent face of the leaflet, the two portions interconnected. Accordingly, in some applications, the influent portion of a stent provides contact pressure on and/or support to a leaflet, e.g., to address flail, prolapse, rigidity, and/or another abnormality. In some applications, the effluent portion and influent portion compress together to create a force to hold to maintain its position on the leaflet. In some applications, a torsion spring is utilized to provide compressive forces. In some applications, a compressive device is contoured to the shape of leaflet. In some applications, a compressive device is texturized on its surface with a roughened surface, indentations, notches, protrusions, and/or barbs to provide further grip to hold the stent in place. In some applications, a compressive device incorporates a wavy ridged wire to provide further grip (like a bobby pin grip). 
     In some applications, a compressive device comprises a wire form stent. Any appropriate material to produce a wire form can be utilized, including (but not limited to) using nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), poly ethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), fluorinated ethylene propylene (FEP), additives thereof, and derivatives thereof. In some applications, a compressive device is contractible, which can be useful to fit within a catheter device for less invasive catheter delivery methodologies. In some applications, nitinol is utilized for its self-expanding properties, which may be useful to implant the compressive device via less invasive catheter delivery methodologies. 
     Various shapes of wire form compressive devices can be utilized in various different implementations. In some applications, a compressive wire form stent is shaped to have portions of the wire form to provide contact pressure on and/or support to the flail, prolapse, rigidity, and/or abnormality. In some applications, a compressive wire form stent has length and width to surround an area of flail or prolapse and utilizes a sheet extending across the area to provide contact pressure on and/or support to the flail, prolapse, rigidity, and/or abnormality. 
     In some applications, a compressive implant or compressive device incorporates a sheet on a wire form. In some applications, a sheet or cover is provided on the influent portion of a compressive device and provides a surface capable of providing contact pressure onto and/or support to a leaflet experiencing flail, prolapse, rigidity, and/or another issue. A sheet or cover can be impermeable, semipermeable, or permeable to fluids (e.g., blood or plasma). In some applications, the sheet or cover is a mesh. In some applications, a mesh is formed utilizing a mesh sheet. In some applications, a mesh is formed utilizing interleaving strings that overlap and intersect. A mesh or permeable sheet can provide contact pressure without restricting the flow of blood or plasma, which can be important in various applications. For instance, an impermeable sheet or cover may trap blood within the compressive device, which in turn may create undesired pressures within the valve or possibly result in pressures that dislodge the implant/device or alter its position. A sheet, covering, and/or mesh herein can comprise any one or more of the following: poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), and polycaprolactone (PCL). 
     Various implementations of compressive devices help promote coaptation of the leaflets when closed. In some applications, a gap filler/coaptation element/spacer is incorporated with the compressive device, which can help fill gaps within the valve aperture. In some applications, a compressive device includes an extended portion with an impermeable sheet that extends from the leaflet lip into the aperture, which can help form coaptation with the other leaflet(s). In some applications, a compressive device includes an extended portion that extends to the effluent face of another valve leaflet to contact the other leaflet when the valve closes such that it assists the opposite leaflet to come together with the stented leaflet and coapt. In some applications, an extended portion that extends to the effluent face of another valve leaflet has a bent angle towards the other leaflet (e.g., to reach another leaflet in a tricuspid, aortic, or pulmonary valve). 
     In some applications, a compressive device includes an anchor to stabilize the stent at the site of implantation. In some applications, the influent portion of a compressive device includes a portion that is in connection with the anchor. In some applications, the anchor connection point is near or in contact with the valve annulus or a ventricle or atrium wall. In some applications, an anchor is situated near or in contact with the valve annulus. In some applications, an anchor is situated near or in contact with the ventricle or atrium wall on the opposite side of the wall from the anchor connection point. In some applications, a connector is utilized to connect the anchor, the connector traversing through the ventricle or atrium wall. Any appropriate connector can be utilized, such as (for example) a screw, rivet, suture, staple, wire, pin, shaft, ribbon, sheet, etc. 
     In some applications, an anchor is situated within vasculature that is on the opposite side of a ventricle or atrium wall. For example, various compressive device implementations mitigate flail, prolapse, rigidity, and/or other abnormalities of the mitral valve and thus are situated within the left atrium. In these various implementations, a compressive device can be connected with an anchor situated within the coronary sinus utilizing a connector traversing through the atrial wall. Any appropriate anchor can be utilized. In some applications, an anchor is wire stent capable of expanding within vasculature. In some applications, an anchor is a pin, pin clamp (e.g., R-clamp, R-pin, R-key) or wire capable of pinning a compressive device via a connector to the ventricle or atrium wall. In some applications, a pin or wire fastener is utilized on the opposite side of a ventricle or atrium wall and the connector traverses the wall. In some applications, a pin or wire fastener is utilized within vasculature that is on the opposite of a ventricle or atrium wall. In some applications, a wire fastener is capable of pinching a connector wire to hold the wire in place and create tension between the wire fastener or wire anchor and the compressive device. In some applications, an anchor comprises a screw, helix, or helical anchor that is anchored within the valve annulus or an atrium or a ventricle wall. 
     In some applications, a compressive device is designed to include space and/or features permitting further medical intervention at a later time. In some applications, a wire form stent includes space within the coaptation area configured as a space between the wires of the wire form such that, if needed sometime in the future, a percutaneous edge to edge mitral valve repair device can still be implanted without the implant/device interfering. 
     Various implementations of compressive devices are to be used on any leaflet experiencing flail or prolapse. Accordingly, in some applications, a compressive device is capable of being utilized on a leaflet of a mitral, a tricuspid, an aortic, and/or a pulmonic valve. Likewise, various implementations of compressive devices can be utilized on any area of the leaflet experiencing flail or prolapse. In some applications, a compressive device is capable of being utilized on or near a leaflet commissure and/or any area between a leaflet&#39;s commissures. 
     To reach the site of implantation, any appropriate surgical technique can be utilized, including (but not limited to) a transcatheter delivery system, which can utilize a transfemoral, subclavian, transapical, transseptal, or transaortic approach. In some applications, a delivery catheter is utilized to incorporate a compressive device, then delivered to the site of deployment via a guidewire and utilized to attach the stent to a leaflet. 
     Some applications are directed to methods of delivering a compressive device to the site of deployment. The various methods described or suggested anywhere herein (including in documents incorporated by reference herein) can be performed on a living animal (e.g., human, mammal, other animal, etc.) or on a non-living simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, tissue, etc. being simulated), etc. Accordingly, methods of delivery include both methods of treatment (e.g., treatment of human subjects) and methods of training and/or practice (e.g., utilizing an anthropomorphic phantom that mimics human vasculature to perform method). 
       FIGS.  32  and  33    illustrate an example implant or device  3201  (e.g., a compressive device, repair device, repair implant, etc.) implanted and/or compressed onto a leaflet  3203  at a site of implantation. As shown here, the implant/device is on the native valve  3205  (e.g., mitral valve, tricuspid valve, etc.). In this example, the valve chordae tendineae is broken  3207  resulting in leaflet flail and/or prolapse in the P2 area  3209  of the posterior leaflet  3203  of the valve  3205 . The implant/device  3201  has an influent portion  3211  and an effluent portion  3213 . The influent portion  3211  is situated on and in contact with the influent face  3215  of the posterior leaflet  3203  within the atrium  3217  at the site of flail and/or prolapse. The effluent portion  3213  is situated on and in contact with the effluent face  3219  of the posterior leaflet  3203  within the ventricle  3221  at the site of flail and/or prolapse. The implant/device acts as a compressive device wherein the influent portion  3211  and the effluent portion  3213  are configured to utilize compressive forces on the flail, prolapse, and/or other abnormality to help flatten out and/or reshape the leaflet (e.g., a protrusion, bulge, etc.) and mitigate regurgitant blood flow. The implant/device  3201  includes a coaptation portion  3223  that extends beyond the edge of the posterior leaflet  3203  and connects the influent portion  3211  and the effluent portion  3213 . 
       FIG.  34    illustrates an example implant or device  3401  (e.g., a compressive device, repair device, repair implant, etc.) with an expanded influent portion  3403  having multiple loops implanted or compressed onto a leaflet  3405  at a site of implantation. As shown here, the implant/device is on the native valve  3407  (e.g., a mitral valve, tricuspid valve, etc.). The implant/device also includes an effluent portion  3409 , indicated by dashed lines. The influent portion  3403  is situated on and in contact with the influent face  3411  of the posterior leaflet  3405  within the atrium  3413  at the site of flail, prolapse, rigidity, and/or abnormality. The effluent portion  3409  is situated on and in contact with the effluent face and of the posterior leaflet  3405  within the ventricle  3415  at the site of flail, prolapse, rigidity, and/or abnormality. The implant/device acts as a compressive device wherein influent portion  3403  and the effluent portion  3409  are configured to utilize compressive forces on the flail, prolapse, rigidity, and/or abnormality to help flatten out and/or reshape the leaflet (e.g., a protrusion, bulge, flail, etc.) and/or mitigate regurgitant blood flow. In addition, the expanded influent portion  3403  with multiple loops increases contact compared to the influent portion of device  3201  and thus can provide additional contact pressure and/or support at the sites of leaflet flail, prolapse, rigidity, and/or abnormality. Accordingly, various device shapes or stent shapes can increase contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality by increasing the amount of contact between the stent and leaflet. The device  3401  includes two coaptation portions  3419  that extend beyond the edge of the posterior leaflet  3405  and connect the influent portion  3403  and the effluent portion  3409 . The two coaptation portions are spaced apart providing an area  3421  for further medical intervention at a later time (e.g., later edge to edge repair, such as implanting a device that holds leaflets together) on the valve leaflets. 
       FIG.  35    illustrates an example implant or device  3501  (e.g., compressive device, repair device, etc.) comprising a wire stent anchor (not shown) at a site of implantation. As shown here, the implant/device is on the native valve  3505  (e.g., mitral valve, tricuspid valve, etc.). The implant/device  3501  has an influent portion  3507  and an effluent portion  3509 , indicated by dashed lines. The influent portion  3507  is situated on and in contact with the influent face  3511  of the posterior leaflet  3513  within the atrium  3515  at the site of flail, prolapse, rigidity, and/or abnormality. The effluent portion  3509  is situated on and in contact with the effluent face and of the posterior leaflet  3513  within the ventricle  3517  at the site of flail, prolapse, rigidity, and/or abnormality. The implant/device acts as a compressive device wherein the influent portion  3507  and the effluent portion  3509  are configured to utilize compressive forces on the flail, prolapse, rigidity, and/or abnormality to help flatten out and/or reshape the leaflet (e.g., a protrusion, bulge, flail, etc.) and mitigate regurgitant blood flow. The implant/device  3501  can include a coaptation portion  3519  that extends beyond the edge of the posterior leaflet  3513  and connects the influent portion  3507  and the effluent portion  3509 . 
     In some applications, the anchor is a wire form expanded within the coronary sinus  3521  adjacent to the left atrium  3515  (or within another blood vessel at or near another chamber of the heart). The anchor  3503  is connected to the compressive device  3501  via a connector  3523  that traverses through the atrium wall  3525 . Accordingly, the anchor helps stabilize the implant/device  3501  at the native valve  3505 . 
       FIGS.  36  to  44    illustrate examples of implants or devices configured as compressive devices (e.g., compressive wire forms and/or stents). In these examples, for the sake of simplicity, a first portion of the compressive device is denoted an influent portion and a second portion is denoted an effluent portion. It is to be understood, however, that an effluent portion can be the influent portion, and that an influent portion can be the effluent portion, as the side of the leaflet in which these portions contact is interchangeable. 
       FIG.  36    illustrates an example implant or device configured as a compressive device or compressive wire form stent  3601 . The device or wire form stent includes an influent portion  3603  and an effluent portion  3605  connected via a coaptation portion  3607 . 
       FIG.  37    illustrates an implant or device configured as a compressive device or compressive wire form stent  3701  in a singular wire that has no wire ends. The wire form stent includes an influent portion  3703  and an effluent portion  3705  connected via a coaptation portion  3707 . 
       FIG.  38    illustrates an implant or device configured as a compressive device or compressive wire form stent  3801  with additional curvature to increase wire contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  3803  and an effluent portion  3805  connected via coaptation portions  3807 . The influent portion  3803  includes two loops  3809 ,  3811  as additional curvature that increases the contact points of the influent portion  3803  with the influent face of a leaflet. The coaptation portions  3807  are spaced apart to allow further subsequent medical intervention (e.g., later edge to edge repair) on the valve leaflets. 
       FIG.  39    illustrates an implant or device configured as a compressive device or compressive wire form stent  3901  with additional curvature to increase wire contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  3903  and an effluent portion  3905  connected via a coaptation portions  3907 . The influent portion  3903  includes outer wing-like loops  3909 ,  3911  and a large inner loop  3913  as additional curvature that increases the contact points of the influent portion  3903  with the influent face of a leaflet. The coaptation portions  3907  are spaced apart to leave a space to allow further medical intervention at some later time (e.g., later edge to edge repair) on the valve leaflets without interference from the implant/device. 
       FIGS.  40  and  41    illustrate an implant or device configured as a compressive device or compressive wire form stent  4001  with a torsion spring. The device or wire form stent includes an influent portion  4003  and an effluent portion  4005  connected via a coaptation portion. The coaptation portion includes a torsion spring  4007  to increase the compression forces provided between the influent portion  4003  and the effluent portion  4005 . The torsion spring  4007  can be situated within an open area on the effluent side of the valve (e.g., within the left ventricle area if used on the mitral valve). 
       FIG.  42    illustrates an implant or device configured as a compressive device or compressive wire form stent  4201  with a connector to connect with an anchor. The wire form stent includes an influent portion  4203  and an effluent portion  4205  connected via a coaptation portion  4207 . A connector  4209  is extended from the influent portion  4203  and connects with an anchor (not shown). In some applications, the connector  4209  is capable of traversing through heart or vasculature tissue. The connector can also be an anchor connection point and/or anchor receiver similar to those described elsewhere herein. For example, in some applications, the compressive device or stent  4201  can comprise an anchor receiver at an anchor connection point configured such that the device  4201  is anchored to the annulus. 
       FIG.  43    illustrates an implant or device configured as a compressive device or compressive wire form stent  4301  with a connector and additional curvature to increase wire contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  4303  and an effluent portion  4305  connected via a coaptation portion  4307 . A connector  4309  is extended from the influent portion  4303  and connects with an anchor (not shown). In some applications, the connector is capable of traversing through heart or vasculature tissue. The influent portion  4303  includes two loops  4311 ,  4313  as additional curvature that increases the contact points of the influent portion  4303  with the influent face of a leaflet. The coaptation portions  4307  are spaced apart to allow further medical intervention at a later time (e.g., subsequent edge to edge repair) on the valve leaflets. The connector can also be an anchor connection point and/or anchor receiver similar to those described elsewhere herein. For example, in some applications, the compressive device or stent can comprise an anchor receiver at an anchor connection point configured such that the device is anchored to the annulus. 
       FIG.  44    illustrates an implant or device configured as a compressive device or compressive wire form stent  4401  with a connector and additional curvature to increase wire contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  4403  and an effluent portion  4405  connected via coaptation portions  4407 . A connector  4409  is extended from the influent portion  4403  and connects with an anchor (not shown). In some applications, the connector is capable of traversing through heart or vasculature tissue. The influent portion  4403  includes a back-and-forth pattern as additional curvature that increases the contact points of the influent portion  4403  with the influent face of a leaflet. The connector can also be an anchor connection point and/or anchor receiver similar to those described elsewhere herein. For example, in some applications, the compressive device or stent can comprise an anchor receiver at an anchor connection point configured such that the device is anchored to the annulus. 
       FIGS.  45  and  46    illustrate an implant or device configured as a compressive device or compressive wire form stent  4501  with a sheet on an influent portion to increase surface contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  4503  and an effluent portion  4505  connected via a coaptation portion  4507 . The influent portion  4503  includes a sheet or cover  4509  that increases the contact points of the influent portion  4503  with the influent face of a leaflet. The sheet or cover can be permeable (e.g., as a mesh, etc.), semipermeable, or impermeable. 
       FIGS.  47  and  48    illustrate an implant or device configured as a compressive device or compressive wire form stent  4701  with a sheet or cover on an influent portion to surface contact with a leaflet prolapse and/or flail. The implant/device can also have an extended coaptation area help the leaflets coapt when the valve is closed. The device or wire form stent includes an influent portion  4703  and an effluent portion  4705  connected via a coaptation portion  4707 . The influent portion  4703  and includes a sheet or cover  4709  that increases the contact points of the influent portion  4703  with the influent face of a leaflet. The coaptation portion  4707  also includes the sheet or cover  4709 , but the coaptation portion  4707  with sheet or cover is extended  4711  such that it capable of extending beyond the leaflet edge when situated upon. 
       FIG.  49    illustrates an implant or device configured as a compressive device or compressive wire form stent  4901  with a sheet on an influent portion to surface contact with a leaflet prolapse and/or flail. This example utilizes the same basic wire form described and shown in  FIG.  38   , and thus includes additional curvature to increase wire contact with a leaflet prolapse and/or flail. The device or wire form stent includes an influent portion  4903  and an effluent portion  4905  connected via a coaptation portion  4907 . The influent portion  4903  includes two loops  4909 ,  4911  as additional curvature that increases the contact points of the influent portion  4903  with the influent face of a leaflet. The influent portion  4903  also includes a sheet or cover  4913  that increases the contact points of the influent portion  4903  with the influent face of a leaflet. The sheet or cover can be permeable, semipermeable, or impermeable. An example comprising a permeable mesh sheet is depicted in  FIG.  50   . 
       FIG.  51    illustrates an implant or device configured as a compressive device or compressive wire form stent  5101  with a sheet on an influent portion to surface contact with a leaflet prolapse and/or flail. This example utilizes the same basic wire form and connector described and shown in  FIG.  42   , and thus includes a connector to connect with an anchor. The device or wire form stent includes an influent portion  5103  and an effluent portion  5105  connected via a coaptation portion  5107 . A connector  5109  is extended from the influent portion  5103  and connects with an anchor (not shown) and is capable of traversing through heart or vasculature tissue. The influent portion  5103  also includes a sheet or cover  5111  that increases the contact points of the influent portion  5103  with the influent face of a leaflet. The sheet or cover can be permeable, semipermeable, or impermeable. An example with a permeable mesh sheet or cover is depicted in  FIG.  52   . 
       FIG.  53    illustrates an implant or device configured as a compressive device or compressive wire form stent  5301  with a sheet on an influent portion to surface contact with a leaflet prolapse and/or flail. This example utilizes the same basic wire form and connector described and shown in  FIG.  44   , and thus includes a connector and additional curvature to increase wire contact with a leaflet prolapse and/or flail. The wire form stent includes an influent portion  5303  and an effluent portion  5305  connected via coaptation portions  5307 . A connector  5309  is extended from the influent portion  5303  and connects with an anchor (not shown) and is capable of traversing through heart or vasculature tissue. The influent portion  5303  includes a back-and-forth pattern as additional curvature that increases the contact points of the influent portion  5303  with the influent face of a leaflet. The influent portion  5303  also includes a sheet or cover  5311  that increases the contact points of the influent portion  5303  with the influent face of a leaflet. The sheet or cover can be permeable (e.g., a mesh, etc.), semipermeable, or impermeable. 
       FIGS.  54  and  55    illustrate an implant or device configured as a compressive implant/device comprising a compressive wire form stent  5401  with an extended and contoured coaptation portion to help leaflet coaptation. The implant/device or wire form stent includes an influent portion  5403  and an effluent portion  5405  connected via a coaptation portion  5407 . The coaptation portion  5407  is extended beyond the edge of a leaflet experiencing issues, e.g., flail, prolapse, rigidity, and/or abnormality. The coaptation portion  5407  is also contoured to be able to reach a leaflet opposite of the leaflet experiencing issues, e.g., flail, prolapse, rigidity, and/or abnormality. The contoured portion lifts and pulls the opposite leaflet towards the leaflet experiencing issues to help the leaflets close. 
       FIG.  56    shows the implant/device depicted in  FIGS.  54  and  55    on a posterior leaflet  5409  of a mitral valve  5411 . The coaptation portion  5407  extends beyond the posterior leaflet  5413  edge and into the left ventricle. The coaptation portion  5407  is also contoured such that, as valve closes, the distal edge of the coaptation portion  5407  contacts the effluent face of the anterior leaflet  5413  to assist bringing the anterior leaflet and posterior leaflet together and coapt. 
       FIGS.  57  and  58    illustrates an implant or device configured as a compressive implant/device comprising a compressive wire form stent  5701  with an attached gap filler, coaptation element, or spacer. The implant/device or wire form stent includes an influent portion  5703  and an effluent portion  5705  connected via a coaptation portion  5707 . The effluent portion  5705  includes a bulky gap filler/coaptation element/spacer  5709  situated near the coaptation portion  5707 . The gap filler/coaptation element/spacer  5709  has a bulky conformation such that it fit within a valve aperture and fill in gaps when the valve is closed. 
       FIG.  59    shows the implant/device depicted in  FIGS.  57  and  58    on a posterior leaflet  5711  of a mitral valve  5713 . When the valve is closed, the gap filler/coaptation element/spacer  5709  situates between the posterior leaflet  5711  and the anterior leaflet  5715  to fill any gaps that may exist. 
       FIGS.  60 A- 60 D  are schematic views of example steps in delivering an implant/device to a native valve via a blood vessel of the heart, described here in the context of delivering an implant/device to a mitral valve via the coronary sinus for illustration (but similar steps can be used at other locations mutatis mutandis). For example, the steps can include accessing the blood vessel or coronary sinus, and traversing through a wall of the coronary sinus and left atrium. The initial steps of reaching the left chambers via the coronary sinus are similar to steps shown  FIGS.  31 A to  31 F  and described in accompanying text. To help understand the delivery process, several figures provide a coronal-plane view within the left chambers sectioning through the coaptation area of the mitral valve. 
     After a puncture catheter is removed from the left chambers (see  FIG.  31 F ), a delivery catheter enters into the left chambers via a guide wire. 
       FIG.  60 A  shows a guide wire  6001  and a delivery catheter  6003  that has been advanced along the guidewire  6001  and through the tissue wall  6005  into the left chambers. A condensed compressive splint device  6007  is being released and expanded within the left ventricle such that compressive splint device  6007  is to be implanted onto a flail, prolapse, rigidity, and/or abnormality of the posterior leaflet. 
       FIG.  65 B  then shows full advancement of the compressive splint device  6007  within left ventricle and the simultaneous retraction of the delivery catheter  6003 . The delivery catheter includes an actuator to actuate the compressive splint device  6007  by opening up the device by distancing an influent portion  6009  of the device from an effluent portion  6011 .  FIG.  60 C  shows the delivery catheter  6003  retracting back toward the coronary sinus, while the actuator positions the influent portion  6009  on the influent face of the mitral valve leaflet and the effluent portion  6011  on the effluent face of the leaflet. A coaptation portion  6013  of the compressive splint device  6007  is pulled towards the mitral leaflet edge such that the compressive splint device  6007  is situated on a leaflet flail, prolapse, rigidity, and/or abnormality. 
       FIG.  60 D  shows further retraction of the delivery catheter  6003 . Subsequently, the entire delivery catheter  6003  is removed along the guide wire  6001  from the body, which is then removed from the body. The delivery process results in the compressive splint device  6007  implanted onto the P2 segment of the mitral valve&#39;s posterior leaflet. 
     Many examples herein are directed towards valve implants or devices for mitigating heart valve leaflet flail, prolapse, rigidity, and/or other abnormalities that include a bar or elongate extension that can span between portions or commissures of a native valve. In some applications, a valve device is capable of situating within the effluent side of a valve, the bar or elongate extension holding onto its place on the leaflet while providing contact pressure onto a region of flail, prolapse, rigidity, and/or abnormality. The contact pressure provided by various bar or extension implants/devices helps flatten out and/or reshape the flail, prolapse, rigidity, and/or abnormality, which helps extend the coapting edge of a leaflet back towards the coaptation area when in a closed position. Proper coaptation that results in a fully closed valve prevents valve regurgitation. 
     In some applications, a bar/elongate extension is configured as an elongated arch with two distal ends, each end having an anchor or means to hook, latch, anchor, fasten, etc. within two leaflet commissures. In some applications, each of the distal ends of the bar/extension includes an indentation or hook, which can help secure the bar/extension within the site of implantation by latching or hooking onto the commissures. In some applications, the bar/extension is telescoped such that there is an inner bar and an outer bar, allowing the bar to be shortened and elongated between a variety of sizes or lengths. Accordingly, in some applications, the telescoping bar/extension can be shortened or elongated to extend over and provide contact pressure upon a leaflet issue, e.g., flail or prolapse. 
     In some applications, a bar/extension/arch includes an anchor to stabilize the bar/extension/arch at the site of implantation beyond the anchors or means to hook, latch, anchor, fasten, etc. within two leaflet commissures (though in some circumstances the anchors or means to hook, latch, anchor, fasten, etc. within two leaflet commissures can be sufficient to secure the implant/device within the native valve without an additional anchor). In some applications, a bar/extension/arch includes a portion that is in connection with the anchor. In some applications, an anchor connection point extends from the bar/extension/arch and towards a ventricle or atrium wall. In some applications, an anchor is situated near or in contact with the ventricle or atrium wall on the opposite side of the wall from the bar/extension/arch connection point. In some applications, a connector is utilized to connect the anchor with the anchor connection point, the connector traversing through the ventricle or atrium wall. Any appropriate connector can be utilized, such as (for example) a screw, rivet, suture, staple, wire, pin, shaft, sheet, mesh, etc. 
     In some applications, an anchor is situated within vasculature that is on the opposite side of a ventricle or atrium wall. For example, various bar or elongate extension examples mitigate leaflet issues (e.g., flail, prolapse, rigidity, and/or abnormality) of the mitral valve and thus are situated within the left atrium. In these various implementations, a bar/extension can be connected with an anchor situated within the coronary sinus utilizing a connector traversing through the atrial wall. Any appropriate anchor can be utilized. In some applications, an anchor is wire stent capable of expanding within vasculature. In some applications, an anchor is a pin (e.g., R-pin) or wire fastener capable of pinning an arched telescoping bar via a connector to the ventricle or atrium wall. In some applications, a pin or wire fastener is utilized on the opposite side of a ventricle or atrium wall and the connector traverses the wall. In some applications, a pin or wire fastener is utilized within vasculature that is on the opposite of a ventricle or atrium wall. In some applications, a wire fastener is capable of pinching a connector wire to hold the wire in place and create tension between the wire anchor or wire fastener and the telescoping bar. In some applications, an anchor is a screw, helix, or helical anchor that is anchored within the valve annulus or wall of an atrium or ventricle. 
     Various implementations of bars, elongate extensions, arches, or arched bars help promote coaptation of the leaflets when closed. In some applications, a gap filler, coaptation element, or spacer is incorporated to extend from the bar/extension/arch and into the valve aperture, which can help fill gaps within the valve aperture. In some applications, a bar/extension/arch includes a sheet extension with an impermeable sheet that hangs off the bar/extension/arch along the leaflet coaptation area and into the valve aperture, which can help form coaptation with the other leaflet(s). In some applications, the sheet includes wire form along the border to help the sheet maintain within the aperture of a valve when implanted. 
     Any appropriate material to produce a bar form, elongate extension, arch, or an arched bar form can be utilized. In some applications, the bar/extension/arch comprises one or more of the following: nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), poly ethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), fluorinated ethylene propylene (FEP), additives thereof, and derivatives thereof. 
       FIG.  61    illustrates an example telescoping bar/extension or telescoping arched bar  6101  capable of situating within a valve and providing contact pressure onto a leaflet flail, prolapse, rigidity, and/or other leaflet abnormality. The telescoping bar/extension or arched bar  6101  as an inner bar/extension  6103  and an outer bar/extension  6105 . The inner bar/extension  6103  is capable of sliding within the outer bar/extension  6105  such that the length of the bar/extension and arc angle can be modulated. In some applications, the bar/extension or arched bar  6101  includes a connector  6107  to connect the bar/extension or arched bar  6101  to an anchor, to provide added stability to the bar/extension or arched bar. In some applications, the bar/extension or arched bar  6101  includes hooks  6109  that are capable of securing within a leaflet commissure or cleft. 
       FIG.  62    illustrates an example a bar/extension device comprising an arch or arched bar  6201  with a sheet extension capable extending a leaflet edge such that it can better coapt. The bar/extension or arched bar  6201  is a single bar/extension that can be situated within the aperture of a valve. In some applications, the bar/extension or arched bar  6201  includes hooks  6203  that are capable of securing within a leaflet commissure or cleft. A sheet  6205  hangs down from the bar/extension or arched bar  6201  to reach and extend beyond a leaflet edge, thus extending the leaflet to provide more area for coaptation. In some applications, the sheet comprises a wire  6207  along its border, which can help hold the sheet within the coaptation area when implanted. 
       FIG.  63    illustrates an example bar/extension device or an arched bar  6301  with a gap filler, coaptation element, or spacer capable of filling a gap(s) within a valve coaptation area when the valve is closed. In some applications, the bar/extension or arched bar  6301  is a single bar/extension that can be situated within the aperture of a valve. In some applications, the bar/extension or arched bar  6301  includes hooks  6303  that are capable of securing within a leaflet commissure or cleft. Multiple gap fillers, coaptation elements, or spacers  6305  hang down from the bar/extension or arched bar  6301  to situate within the valve coaptation area helping the leaflets coapt by filing in any gaps when the leaflet is closed. 
     Some examples herein are directed towards implants or devices comprising netting (e.g., mesh, sheet, drape, etc.) for mitigating heart valve leaflet issues, such as flail, prolapse, rigidity, and/or other abnormalities. In some applications, a netting implant/device is capable of situating within the effluent side of a valve, the lateral edges situated within a crevice within the heart valve (e.g., cleft or commissure) while providing contact pressure onto and/or support to a region of flail, prolapse, rigidity, and/or abnormality. The contact pressure provided by various netting devices/implants helps flatten out and/or reshape the leaflet or the flail, prolapse, rigidity, and/or abnormality of the leaflet, which helps extend the coapting edge of a leaflet back towards the coaptation area when in a closed position. Proper coaptation that results in a fully closed valve prevents valve regurgitation. 
     In some applications, a netting implant/device includes (but is not limited to) one face configured to directly contact the face of a leaflet experiencing flail, prolapse, rigidity, and/or other issues. Typically, the influent face of a leaflet is the face that experiences flail, prolapse, rigidity, and/or other issues. In some applications, the contact face of the netting device is pliable and thus contours to the influent face of a leaflet, which can be a hyperbolic paraboloid-like contour. In some applications, the contact face of the netting device provides contact pressure on a leaflet flail, prolapse, rigidity, and/or abnormality. In some applications, the contact face of the netting implant/device has a width and a length such that it can cover the region of the leaflet experiencing flail, prolapse, rigidity, and/or abnormality. In some applications, the length of an implant/device extends just beyond the coaptation area of the leaflet. 
     In some applications, a netting implant/device includes an anchor to stabilize the device at the site of implantation. In some applications, an anchor is situated near or in contact with the valve annulus, leaflet area, or atrium/ventricle wall. In some applications, an anchor is a screw, helix, helical anchor, or other feature capable of screwing within or embedding within the valve annulus, leaflet, or atrium/ventricle wall. In some applications, a helical anchor is housed within a tubular compartment, the tubular compartment connected to or a part of the netting implant/device to be anchored. 
     In some applications, an anchored netting implant/device incorporates a tether for further stabilization at the site of implantation. In some applications, a tether extends from the coaptation portion of a netting implant/device to a pinning location on the effluent side of the valve, where the tether is pinned down. The pinning location can be any sturdy feature, such as (for example) ventricle wall, atrium wall, papillary muscle, and/or nearby vasculature. 
     The netting of a netting device can be impermeable, semipermeable, or permeable to fluids (e.g., blood or plasma). In some applications, the netting is a mesh. In some applications, a mesh is formed utilizing interleaving strings that overlap and crisscross. In some applications, a mesh is formed utilizing a mesh sheet. Any appropriate material can be utilized for a netting, for example, a netting can comprise one or more of the following: poly(lactic-co-glycolic) acid (PLGA), polyvinylchloride (PVC), polyethylene (PE), polypropylene (PP), polytetrafluoroethylene (PTFE), polyurethane (PU), polyethylene terephthalate (PET), polyethersulfone (PES), polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), poly-4-hydroxybutyrate (P4HB), and polycaprolactone (PCL). Any appropriate means to attach a netting to an anchor(s) can be utilized, including (but not limited to) stitching, staples, and glue. 
     In some applications, a netting device includes a wire form outlining the netting or a portion of the netting. Any appropriate material to produce a wire form can be utilized, for example, the wire form can comprise one or more of the following: nitinol, cobalt-chrome (CoCr), stainless steel, titanium, polyglycolic acid (PGA), polylactic acid (PLA), poly-D-lactide (PDLA), polyurethane (PU), poly-4-hydroxybutyrate (P4HB), polycaprolactone (PCL), polyether ether ketone (PEEK), cyclic olefin copolymers (COCs), poly ethylene vinyl acetate (EVA), polytetrafluorethylene (PTFE), perfluoroether (PFA), fluorinated ethylene propylene (FEP), additives thereof, and derivatives thereof. 
     In some applications, a netting device is contractible, which may be useful to fit within a catheter device for less invasive catheter delivery methodologies. In some applications, nitinol is utilized for its self-expanding properties, which may be useful to implant the device in less invasive catheter delivery methodologies. 
     Some applications of netting devices are configured to be used on any leaflet experiencing flail or prolapse. Accordingly, in some applications, a netting device is capable of being utilized on a leaflet of a mitral, a tricuspid, an aortic, and/or a pulmonic valve. Likewise, various devices/implants can be utilized on any area of the leaflet experiencing flail or prolapse. In some applications, a netting device is capable of being utilized on any area between a leaflet&#39;s crevices (e.g., commissures and clefts). 
     To reach the site of implantation, any appropriate surgical technique may be utilized, including (but not limited to) a transcatheter delivery system, which can utilize a transfemoral, subclavian, transapical, transseptal, or transaortic approach. In some applications, a delivery catheter is utilized to incorporate a device, then delivered to the site of deployment via a guidewire and utilized to anchor the device at the site of implantation. 
     Some examples herein are directed to methods of delivering a netting device to the site of deployment. The various methods described or suggested anywhere herein (including in documents incorporated by reference herein) can be performed on a living animal (e.g., human, mammal, other animal, etc.) or on a non-living simulation, such as on a cadaver, cadaver heart, simulator (e.g., with the body parts, tissue, etc. being simulated), etc. Accordingly, methods of delivery include both methods of treatment (e.g., treatment of human subjects) and methods of training and/or practice (e.g., utilizing an anthropomorphic phantom that mimics human vasculature to perform method). 
       FIG.  64    illustrates an example netting implant or netting device  6401  with a helical anchor  6403 . The netting implant/device  6401  is shown with a mesh material  6405  that extends from anchoring portion  6407 . The lateral edges  6409  and  6411  of the netting implant/device  6401  can be positioned into a crevice of the heart valve (e.g., commissure or cleft) and the mesh material  6405  can be positioned over an provide contact pressure upon a leaflet to address flail, prolapse, rigidity, and/or other issues. The lateral edges  6409  and  6411  can optionally incorporate a wire form. The coaptation portion  6413  can optionally include a tether or weight to further stabilize the netting the device at the site of implantation. 
       FIGS.  65  and  66    an example depicting the netting implant/device  6401  with a helical anchor  6403  at a site of implantation. As shown here, the netting implant/device is on the mitral valve  6415 . The contact face of the netting implant/device  6401  is situated on the influent face of the posterior leaflet within the left atrium  6419  at the site of flail, prolapse, rigidity, and/or abnormality. The contact face can provide contact pressure onto and/or support to the leaflet, e.g., to address flail, prolapse, rigidity, and/or abnormality and to help flatten out and/or reshape the leaflet or a protrusion, bulge, flail, etc. of the leaflet and mitigate regurgitant blood flow. The implant/device  6401  includes a coaptation portion  6413  that extends beyond the edge (e.g., below the edge) of the posterior leaflet and into the left ventricle  6417 . 
     The lateral edges  6409  and  6411  of the netting implant/device  6401  can be positioned into the clefts between P1 and P2  6419  and between P2 and P3  6421 . Any of the anchors described herein can be used. In some applications, the anchor  6403  is a helical anchor configured to be anchored into the valve annulus  6423 . The anchor  6403  stabilizes the netting device  6401  at the native valve  6415 . 
     Reference is made to  FIGS.  67 A-B ,  68 A-G, and  69 - 75 , which are schematic illustrations of a system  20  for use with a valve of a heart  4  of a subject, in accordance with some applications. System  20  is shown being used with a mitral valve  10  of the heart, the heart chamber upstream of the mitral valve being left atrium  6 , and the heart chamber downstream of the mitral valve being left ventricle  8 . However, system  20  can also be used, mutatis mutandis, with the other atrioventricular valve (the tricuspid valve) from which another atrium (the right atrium) is upstream, and another ventricle (the right ventricle) is downstream. System  20  can also be used with the aortic valve or the pulmonary valve, from which the heart chamber upstream is a ventricle (the left ventricle and the right ventricle, respectively). 
     System  20  comprises an implant  100 , an anchor  30 , a catheter  40 , and a delivery tool  50 . Implant  100  comprises an interface  110 , and a flexible wing  120 , coupled to the interface. Wing  120  can comprise a contact face or surface  122  and an opposing face or surface  123  opposite the contact face. For some applications, implant  100  can have features or elements similar to those described for implant  1101 , implant  2101 ,  2301 , and/or  2421  described hereinabove, mutatis mutandis. 
     Delivery tool  50  can comprise a shaft  60  and a driver  70 . Shaft  60  is configured to engage interface  110 , and via this engagement, to deploy and position implant  100 , e.g., as described in more detail hereinbelow. This engagement can be achieved by shaft  60  having a shaft head  62  that comprises one or more couplings  64 , such as latches or arms, which engage one or more couplings  114  (e.g., recesses, slots, notches, or receptacles) of interface  110 . 
     Driver  70  is configured to engage anchor  30  (e.g., a head  32  thereof), and is configured to secure implant  100  to tissue of the heart by using the anchor to anchor interface  110  to the tissue. In some applications, driver  70  comprises a flexible shaft  74  and a drive head  72  at a distal end of the shaft, the drive head engaging anchor  30 . 
     For some applications, and as shown, wing  120  comprises a frame (e.g., a wire frame)  124 , and a sheet  126  spread over the frame. For some applications, wing  120  has a root  130  that is coupled to interface  110 , and a tip  132  at an opposite end of the wing from the root. Tip  132  represents a free end of wing  120 . 
     For some applications, frame  124  is attached to interface  110 . For example, and as shown, at root  130  frame  124  may define a ring  128  that fits around interface  110 . Wing  120  may define two lateral sides  134  (e.g., a first lateral side  134   a  and a second lateral side  134   b ) extending from the root to the tip. 
     For some applications, and as shown, frame  124  defines two loops  136  (e.g., a first loop  136   a  and a second loop  136   b ) extending from root  130  alongside each other, e.g., all the way to tip  132 . It is to be noted that, as shown, loops  136  can be discrete loops, rather than cells of a cellular or lattice structure. For example, loops  136  can be unconnected to each other and/or to any other metallic component of implant  100  except for at root  130  (e.g., at ring  128  and/or interface  110 ). Furthermore, each of loops  136  can be configured to circumscribe a space  137  that is substantially absent of frame components. For some applications, and as shown, each of loops  136  is substantially teardrop-shaped. 
     For some applications in which frame  124  defines loops  136 , frame  124  defines an elongate space  138  between the two loops. Space  138  can extend from root  130  toward tip  132 , e.g., all the way to the tip (e.g., such that the frame  124  does not bridge the two loops at the tip). For some applications, and as shown, space runs  138  along a plane of reflectional symmetry of wing  120 . 
     For applications in which frame  124  defines loops  136 , sheet  126  can be configured to extend over and between the loops, e.g., across both loops and space  138 . 
     For some applications, sheet  126  has a plurality of holes  140  therethrough. For some such applications, and as shown, holes  140  are polygonal and tessellated with each other. For example, and as shown, holes  140  can be hexagonal. As shown, some of holes  140  can be disposed over spaces  137 . Alternatively or additionally, some of holes  140  can be disposed over space  138 . For some applications, and as shown, the size and number of openings or holes  140  is such that the wing  120  (or its area/surface area) is, overall, more than 20 percent and/or less than 80 percent open, e.g., 20-80 percent open, such as 20-70 percent open (e.g., 30-70 percent open, such as 30-60 percent open or 40-70 percent open) or 30-80 percent open (e.g., 40-80 percent open). 
     In some applications, wing  120  is curved, such that contact face  122  is concave. That is, a curvature of wing  120  is such that, in a cross-section of implant  100  through interface  110  and the wing, contact face  122  is concave.  FIG.  67 B  is a schematic illustration of this cross-section, and in  FIG.  67 A  the position of the cross-section is shown by the indicators A. However,  FIG.  67 B  shows implant  100  with anchor  30  in place, e.g., as though the implant has been implanted. As shown, this cross-section can be in a plane of reflectional symmetry of the implant, e.g., in space  138 , between loops  136 . For some applications, and as shown, the curvature of wing  120  increases with distance from interface  110 , e.g., such that the curvature is greatest at tip  132 . For example, and as shown in  FIG.  67 B , at tip  132 , following anchoring of implant  100  by anchor  30 , a tangent ax 2  of the curvature of wing  120  can be less than 60 degrees, (e.g., less than 45 degrees, such as less than 35 degrees) with respect to an anchor axis ax 1  of anchor  30 . This angle between tangent ax 2  and axis ax 1  can be at least in part dictated by geometry of interface  110  and/or an anchor receiver  150  at the interface (described hereinbelow), e.g., with respect to geometry of anchor  30 . 
     For some applications, and as described in more detail hereinbelow, an angular disposition of wing  120  with respect to interface  110  and/or anchor receiver  150  is such that positioning the interface against tissue of an atrium of the heart (e.g., against an annulus of an atrioventricular valve of the heart, or against a wall of the atrium) disposes tip  132  within the ventricle that is downstream of the atrium and the atrioventricular valve. 
       FIGS.  68 A-G  show at least some steps in the implantation of implant  100 , in accordance with some applications. Within catheter  40 , implant  100  is advanced to a heart chamber that is upstream of the heart valve that is to be treated ( FIG.  68 A ). For example, catheter  40  can be advanced to the chamber prior to advancing implant  100  through the catheter, or the catheter can be advanced to the chamber with the implant already disposed therein. In the illustrated example, mitral valve  10  of heart  4  is being treated, and therefore implant  100  is advanced to left atrium  6  of the heart. Mitral valve  10  has a first leaflet (e.g., a posterior leaflet)  12  and an opposing leaflet (e.g., an anterior leaflet)  14 . In the illustrated example, the posterior leaflet is the leaflet that is experiencing flail. The part of the posterior leaflet that is flailing is indicated by reference numeral  16 . It is to be noted that, system  20  can similarly be used to treat flail in anterior leaflet  14 , mutatis mutandis. 
     In the example shown, catheter  40  is advanced to the heart chamber transluminally. However, a transatrial approach is also within the scope of the disclosure. Similarly, although a transfemoral approach is shown, the scope of the disclosure includes advancement via the superior vena cava. It is to be noted that, although a transseptal approach is shown from right atrium  5  into left atrium  6 , the interatrial septum is not shown, as it lies behind aorta  7 . Part of catheter  40  is shown in phantom in order to illustrate that it is behind aorta  7 . 
     As shown, the advancement of implant  100  within catheter  40  is performed while shaft  60  (e.g., head  62  thereof) is engaged with interface  110  of the implant. In some applications, implant  100  is advanced within catheter  40  while wing  120  is constrained (e.g., compressed, folded, and/or rolled) within the catheter. 
     Using shaft  60 , implant  100  is deployed out of catheter  40  such that, within atrium  6 , wing  120  extends away from interface  110  ( FIGS.  68 B-C ). For some applications, upon deployment wing  120  automatically expands toward the shape described with reference to  FIGS.  67 A-B , e.g., due to elasticity and/or shape memory of frame  124 . 
     Subsequently, again using shaft  60 , implant  100  is positioned in a position in which interface  110  is at a site  18  in the heart, wing  120  extends over first leaflet  12  toward opposing leaflet  14 , and contact face  122  faces the first leaflet ( FIG.  68 D ). For some applications, and as shown, wing  120  extends over first leaflet  12  such that tip  132  is disposed beyond (e.g., downstream) the lip of the first leaflet, e.g., within left ventricle  8 , e.g., with opposing face  123  facing opposing leaflet  14 . Typically, this is due at least in part to the geometry and dimensions of implant  100 , and/or at least in part to site  18 . Site  18  can be, but not necessarily, on the annulus of the valve being treated, e.g., at the root of the leaflet that is experiencing flail. Thus, in the example shown, wing  120  extends from interface  110  at site  18  on mitral annulus  11  at the root of posterior leaflet  12 , over posterior leaflet  12  toward opposing leaflet  14 , and curves downstream between leaflets  12  and  14 , beyond the lip of leaflet  12 , such that tip  132  is disposed within ventricle  8 . 
     For some applications, and as shown, wing  120  (and optionally implant  100  as a whole) is entirely deployed (i.e., exposed) from catheter  40  prior to being positioned against the tissue. 
     The wing  120  can be configured to be at a variety of angles relative to the catheter shaft and/or relative to the native anatomy (e.g., the annulus and/or leaflet) during delivery to appropriately repair the function of the native leaflet as it is positioned for anchoring, for example, in some applications, the device is angled between 20-160 degrees, between 30-150 degrees, between 40-140 degrees, between 50-130 degrees, between 60-120 degrees, between 70-110 degrees, etc. relative to an axis of the tip of the catheter (and/or relative to a plane of the annulus) during delivery. 
     Optimality of a given position of implant  100  can be determined during the implantation procedure, e.g., prior to anchoring the implant to the tissue. For example, optimality can be determined using blood pressure sensing and/or imaging techniques such as fluoroscopy and echocardiography. For example, Doppler echocardiography can be used to determine a degree to which regurgitation through the valve remains or has been reduced. In order to illustrate an advantage of system  20 ,  FIG.  68 D  shows implant  100  having been initially positioned suboptimally, e.g., with wing  120  positioned away from flail  16 . That is, site  18  is an initial site  18   a  at which interface  110  has been positioned. At this point, implant  100  has not yet been anchored to tissue, and interface  110  can simply be moved to another site  18 , e.g., a second site  18   b  ( FIG.  68 E ). For example, interface  110  can be simply slid along annulus  11 . Alternatively, the interface can be lifted away from the tissue at the first location, and then replacing it against the tissue at the second location. As shown, this repositioning can be performed without withdrawal (e.g., even partial withdrawal) of implant  100  into catheter  40 . In the illustrated example, this second position of implant  100  is more suitable than the first (e.g., is optimal), e.g., wing  120  is disposed over flail  16 , and valve regurgitation is minimized or eliminated. 
     Upon determining that implant  100  is positioned suitably (e.g., optimally), the implant is secured in its position by anchoring interface  110  to tissue of the heart, e.g., at the current site  18  ( FIG.  68 F ). This can be achieved by using driver  70  to advance anchor  30  distally while maintaining the position of implant  100 . Subsequently, driver  70  (e.g., drive head  72  thereof) is disengaged from anchor  30 , shaft  60  (e.g., shaft head  62  thereof) is disengaged from interface  110 , and tool  50  is removed, leaving implant  100  in place. 
     It is to be noted that tip  132 , which is a free end of wing  120 , is typically not anchored to tissue during the implantation process. It is to be further noted that, at least for applications in which interface  110  is anchored to annulus  11 , implant  100  is typically not anchored downstream of the leaflets of the valve being treated (e.g., within the ventricle downstream of the valve being treated), e.g., implant  100  does not comprise a downstream anchor (e.g., a ventricular anchor). For example, and as shown, at least for applications in which interface  110  is anchored to annulus  11 , any anchoring of implant  100  to tissue of the heart is typically within the atrium upstream of the valve being treated. 
     For some applications, implant  100  can be repositioned even after anchoring, by driver  70  being used to de-anchor interface  110  from the tissue (e.g., by unscrewing anchor  30 ). 
       FIG.  68 G  shows implant  100  following its implantation, and subsequently to disengagement of tool  50  from the implant (e.g., disengagement of driver  70  from anchor  30 , and disengagement of shaft  60  from interface  110 ), and withdrawal of the tool from the subject. 
     It is hypothesized that the simplicity of repositioning implant  100  is at least in part due to the simplicity and minimalistic nature of the implant itself, and/or due to the simplicity of its anchoring (e.g., via a single anchor). It is further hypothesized that, because shaft  60  holds implant  100  in each position in which the implant will potentially be secured (e.g., because the shaft holds interface  110  at (e.g., against) each site  18  to which the interface will potentially be anchored), and because the subsequent anchoring of the implant causes minimal (e.g., no) alteration in the implant&#39;s position, the determination of position optimality described hereinabove is, advantageously, particularly accurate and reliable for system  20 . It is still further hypothesized that this advantage can be additionally facilitated by the complete deployment of wing  120  (e.g., of implant  100  as a whole) prior to placing the implant at each position. 
     Moreover, if it is decided to abort the implantation after implant  100  has been deployed in the atrium, it is possible to withdraw the implant into catheter  40  and out of the subject simply by retracting shaft  60  into the catheter. The shape and flexibility of wing  120  facilitate it being recompressed by its reentry into the catheter. If interface  110  has already been anchored before the decision to abort has been made, driver  70  can be used to de-anchor anchor  30  before retraction of shaft  60 . 
     Further regarding the simplicity of implant  100 , for some applications, implant  100  consists essentially of interface  110  and wing  120  (i.e., frame  124  and sheet  126 ). 
     For some applications, and as shown, driver  70  is disposed within shaft  60 , and can advance anchor  30  through the shaft. For some such applications, and as shown, driver  70  and anchor  30  can be present within shaft  60  throughout the procedure. In some applications, driver  70  and anchor  30  can be introduced into shaft  60  after implant  100  has been introduced to the heart. 
     Anchor  30  can include a tissue-engaging element  34 , and driver  70  can anchor interface  110  to the tissue by driving the tissue-engaging element into the tissue. Tissue-engaging element  34  can take one of various forms known in the art, such as helical, dart, staple, etc. In the example shown, tissue-engaging element  34  is a helical tissue-engaging element, which driver  70  screws into the tissue. 
     For some applications, implant  100  comprises an anchor receiver  150  at interface  110  (or interface  110  comprises an anchor receiver  150 ), such that the anchoring of the interface to the tissue is achieved by anchoring the receiver to the tissue. This itself can be achieved by using driver  70  to anchor anchor  30  to receiver  150 , e.g., by driving the anchor through the receiver and into the tissue. 
     For some applications, and as shown, receiver  150  defines an aperture therethrough, and includes an obstruction  152  that protrudes medially into or across the aperture. For such applications, anchor  30  and driver  70  can be configured such that the driver can drive tissue-engaging element  34  beyond obstruction  152  until head  32  becomes obstructed by the obstruction. 
     For some applications, receiver  150  can be similar to and/or can be substituted with an anchor connection point described hereinabove, such as anchor connection point  2107 , mutatis mutandis. 
     Reference is now made to  FIGS.  69 ,  70 , and  71   , which are schematic illustrations of valve  10  during a transition from ventricular diastole to ventricular systole, in accordance with some applications. In frames B-D of each of these figures, a series of small arrows pointing upwards represent pressure from ventricle  8  contracting during ventricular systole.  FIG.  69    shows valve  10  as a healthy valve  10 , whereas  FIGS.  70 - 71    show valve  10  as an injured valve  10  in which leaflet  12  is experiencing flail (e.g., as described for valve  10  hereinabove).  FIG.  70    shows the injured valve  10  before implantation of implant  100 , whereas  FIG.  71    shows the valve after implantation of the implant, in accordance with some applications. In each of  FIGS.  69 - 71   , frames A-D represent sequential snapshots during the transition from ventricular diastole to ventricular systole. When viewed in reverse order frames D-A can be considered to represent sequential snapshots during the return transition from ventricular systole to ventricular diastole. 
     In healthy valve  10 , leaflets  12  and  14  close synchronously during ventricular systole, thereby coapting and preventing retrograde flow into atrium  6 . In injured valve  10 , flail  16  occurs at a site on leaflet  12  (e.g., due to one or more damaged chordae tendineae), thereby allowing retrograde leakage into atrium  6 . Previously-described treatments for flail are based on inhibiting movement of the leaflet in an atrial direction (e.g., along an atrioventricular axis ax 3 ), such as by implanting a constraining device in the ventricle (e.g., a prosthetic chorda tendinea) or in the atrium (e.g., an obstructing frame), the constraining device opposing (e.g., directly opposing) the ventriculo-atrial movement of the flail, and thereby requiring substantial strength to oppose the force that ventricular pressure applies to the leaflet. It is hypothesized that implant  100  advantageously manipulates the force of the ventricular pressure, deflecting the otherwise ventriculo-atrial movement of leaflet  12  toward opposing leaflet  14 , such that the part of leaflet  12  that would otherwise flail coapts with leaflet  14 —albeit with wing  120  sandwiched therebetween. 
     It is hypothesized that this directed coaptation simulates physiological coaptation in a healthy valve, allowing the leaflets to cooperatively resist ventricular pressure. That is, due to the directed coaptation leaflet  14  provides leaflet  12  with support to resist flailing. It is further hypothesized that, due to this, implant  100  advantageously does not require the substantial strength that would be required to oppose the force applied by ventricular pressure. Instead, advantageously, implant  100  can be anchored by a single anchor (though multiple anchors can also be used), can be implanted using a simple and highly maneuverable delivery system, and wing  120  can be highly flexible. For some applications, implant  100  and/or its anchoring can in fact be insufficiently strong to directly resist (e.g., obstruct) leaflet  12  from flailing in response to the force from ventricular pressure—but is nonetheless able to reduce or eliminate the flail by (re)directing the leaflet toward the opposing leaflet. 
     Comparison of  FIGS.  70  and  71    further illustrate an example of this hypothesized behavior, although this example should not be construed as limiting the scope of the disclosure. In  FIG.  70   , frames B-D show uninjured leaflet  14  swinging toward leaflet  12  in response to ventricular pressure. That is, although the ventricular pressure is broadly directed atrially (e.g., along axis ax 3 ), and although leaflet  14  moves atrially in response to this pressure, it also swings/deflects toward leaflet  12 . In a healthy valve, both leaflets behave in this manner, and thereby coapt ( FIG.  69   ). In contrast, in  FIG.  70   , injured leaflet  12  (e.g., flailing part  16  thereof) has relatively less movement toward leaflet  14  and is thereby able to slip past the lip of leaflet  14  and flail into atrium  6 . In  FIG.  71   , implant  100  (e.g., wing  120  thereof) redirects leaflet  12  toward leaflet  14 , facilitating sealing of valve  10 . 
     In many applications, portions of the native leaflet being treated (e.g., leaflet  12 ) still directly coapt against another native leaflet. In some cases, more than 20%, more than 30%, more than 40%, more than 50%, more than 60%, or more than 70% of the native leaflet being treated (or of a coaptation surface of the native leaflet) coapts directly against another native leaflet. Further, typically, at least during part of the cardiac cycle (e.g., ventricular diastole), the native leaflet being treated (in this case leaflet  12 ) separates from wing  120  ( FIG.  71   , frame A), and during another part of the cardiac cycle (e.g., ventricular systole), the leaflet becomes pushed against wing  120  by ventricular pressure. Thus, wing  120  does not serve as a prosthetic leaflet, but rather a guide and/or support for the native leaflet, aiding the native leaflet to assume an appropriate conformation for coaptation with the opposing leaflet. It is hypothesized that, at least for some applications, the shape of wing  120  and/or the position and orientation in which implant  100  is implanted is such that, during systole, the native leaflet becomes molded to or follows or conforms to the shape of wing  120  as contact between the native leaflet and the wing propagates toward the lip of the leaflet and tip  132  of the wing, e.g., as shown. Implant/device  100  (and any of the implants/devices herein) can be beneficially configured to extend beyond (and/or below) the edge of the native leaflet (e.g., when the valve is closed). It is hypothesized that this may beneficially help ensure the leaflet assumes the correct shape without requiring the end of the implant/device  100  to be anchored in the ventricle or clipped to the edge of the native leaflet. 
     It is hypothesized that holes  140  (or other opening(s)) facilitate the native leaflet becoming molded to or following or conforming to the shape of the wing by allowing blood to flow downstream through wing  120  during diastole (e.g., pushing leaflet  12  away from the wing), and allowing blood to escape from between the leaflet and the wing during the first moments of systole, thereby allowing the leaflet to promptly flatten against the wing and coapt with the opposing leaflet, thus facilitating a small regurgitant volume. A permeable portion and/or and open/uncovered portion similar to that described with respect to  FIG.  21 A  may provide similar benefits, and it is possible to include or use covered portions and/or uncovered portions with this device that are similar to those show and described with respect to  FIG.  21 A . The hole(s), open portion(s), and/or permeable portion may also help facilitate implantation in a beating heart and allow easier positioning of the device, without the circulating blood catching the wing like a sail and causing too much movement of the wing or device. This may similarly help avoid undesired device/implant migration after implantation. 
     Typically, and as shown, wing  120  beats or moves during the cardiac cycle, e.g., facilitated by manner in which implant  100  is anchored, and/or by the flexibility of the wing (e.g., of frame  124 ). For example, as the leaflet being treated is pushed upstream by ventricular pressure, it pushes wing  120  upstream. The transition from frame A to frame B of  FIG.  71    represents implant  100  as a whole pivoting about anchor  30  in response to leaflet  12  being pushed against wing  120 , e.g., due to implant  100  being anchored only at interface  110 . The transition from frame B to frame C of  FIG.  71    represents wing  120  deflecting with respect to interface  110  and anchor  30  in response to further pushing of the wing by leaflet  12 , e.g., due to the flexibility of the wing (e.g., of frame  124 ). 
       FIG.  72 A  schematically illustrates an implant  100   a ,  FIG.  72 B  schematically illustrates an implant  100   b , and  FIG.  72 C  schematically illustrates an implant  100   c . Implants  100   a ,  100   b , and  100   c  are variants of implant  100 . Implants  100   a ,  100   b , and  100   c  can be identical to each other except that implant example  100   a  comprises a receiver  150   a  of anchor receiver  150  or interface  110 , implant example  100   b  comprises a receiver  150   b  of anchor receiver  150  or interface  110 , and implant example  100   c  comprises a receiver  150   c  of anchor receiver  150  or interface  110 . 
     Receiver  150   a  comprises an example obstruction element  152   a  of obstruction  152 . Obstruction element  152   a  is defined by part of sheet  126  extending over the aperture defined by the anchor receiver. During anchoring, tissue-engaging element  34  is driven through and beyond the sheet (e.g., piercing the sheet) until head  32  becomes obstructed by (e.g., abuts) the sheet, e.g., pressing/sandwiching the sheet toward/against the tissue. For some applications, receiver  150   a  has features in common with those described with reference to  FIGS.  24 C-D , mutatis mutandis. For example, the part of sheet  126  that defines obstruction element  152   a  may define a hinge that is similar to hinge  2427 , described with reference to  FIGS.  24 C-D . 
     Receiver  150   b  comprises an example obstruction element  152   b  of obstruction  152 . Obstruction element  152   b  comprises (or is defined by) a cross-bar that traverses the aperture defined by the anchor receiver. During anchoring, tissue-engaging element  34  is driven beyond the cross-bar until head  32  becomes obstructed by (e.g., abuts) the cross-bar, e.g., pressing/sandwiching the cross-bar toward/against the tissue. For some applications, receiver  150   b  has features in common with those described with reference to  FIGS.  23 B-C , mutatis mutandis. For example, the cross-bar that defines obstruction element  152   b  can correspond or be similar to the cross-bar that traverses aperture  2317 . For some applications, the cross-bar that defines obstruction element  152   b  can correspond or be similar to fulcrum  1905 , described with reference to  FIG.  19 A , mutatis mutandis. 
     Receiver  150   c  comprises an example obstruction element  152   c  of obstruction  152 . Obstruction element  152   c  comprises (or is defined by) a collar. During anchoring, tissue-engaging element  34  is driven beyond the collar until head  32  becomes obstructed by (e.g., abuts) the collar, e.g., pressing/sandwiching the collar toward/against the tissue. 
     A variety of different types of obstruction elements are also possible, e.g., sheet(s), fabric(s), weave(s), panel(s), metal (e.g., metal sheet, metal fabric, metal structure configured to interface with anchor, etc.), one or more holes (e.g., hole(s) sized for allowing tissue penetration portion of anchor to pass, but not anchor head), cross-bar(s), collar(s), hub(s), polymer layer(s), mesh, nut(s), threaded portion(s) (e.g., with threads that interact with anchor to allow tissue penetration, but keep anchor attached to device), stop(s), etc. 
     For some applications, implant  100  comprises a lateral (e.g., tubular) wall  112  that defines at least part of interface  110 , and in which couplings  114  may be defined. For example, implant  100  can comprise a housing  108  that comprises or defines interface  110  (e.g., wall  112  and couplings  114  thereof), and receiver  150  (e.g., obstruction  152  thereof). Housing  108  can be formed from a single piece of stock, integrating all of these elements. Housing  108  can have features in common with housing  2313 , described hereinabove, mutatis mutandis. 
     For some applications, implant  100  comprises a counterforce support, such as support  1113  and/or support  2309 , described hereinabove. For some such applications, during delivery the counterforce support is disposed proximally from interface  110  and/or receiver  150  while within catheter  40 . For example, the counterforce support can be deployed from catheter  40  only after the optimal position of implant  100  has been identified and/or only after interface  110  has been anchored to the tissue (e.g., such that while wing  120  is being deployed out of the catheter, shaft  60  extends, within the catheter, proximally away from the interface and past the counterforce support). Alternatively, despite the counterforce support being disposed proximally from interface  110 , it can be deployed from catheter  40  prior to placement of interface  110  against the tissue. For some applications, during delivery the counterforce support is disposed distally from interface  110  and/or receiver  150  (e.g., alongside wing  120 ) while within catheter  40 , and can be deployed from the catheter simultaneously with the wing. 
     Once deployed, the counterforce support extends from interface  110  and away from wing  120 , and following implantation of implant  100  typically lies against the wall of the chamber in which the implant has been implanted, e.g., similarly to as described with reference to  FIGS.  11 - 12   , mutatis mutandis. 
     Reference is made to  FIG.  73   , which is a schematic illustration of multiple implants  100  having been implanted at a single heart valve, in accordance with some applications. Advantageously, and at least in part due to the simplicity of implant  100 , the implant typically allows for the implantation of multiple implants  100  at the same valve. It is hypothesized that the simplicity of implant  100  and/or the flexibility of wing  120  allows such multiple implants to be implanted without preventing the underlying leaflet from coapting with the opposing leaflet—even with wings  120  of the implants overlapping, e.g., as shown. 
     Although all three implants  100  in  FIG.  73    are shown over the same leaflet, it is to be understood that the scope of the disclosure includes implanting one or more implants  100  over one leaflet of the valve, and one or more implants  100  over another leaflet of the valve. 
     Furthermore, implant  100  is compatible with the implantation of other implants, either before or after the implantation of implant  100 . For example, because implant  100  has a relatively small footprint on the valve annulus, an annuloplasty structure could also be implanted, if necessary. Similarly, because wing  120  is flexible, if it were to be subsequently determined that the subject requires a prosthetic valve to be implanted at the heart valve (e.g., due to further deterioration of the condition being treated), a transluminally-delivered prosthetic valve can be implanted without removing implant  100 , e.g., by wing  120  being simply pushed/deflected laterally by the expansion of the prosthetic valve. It is hypothesized that the size and simple design of wing  120  would mean that the wing would not obscure the outflow of a prosthetic valve implanted without removing the implant. 
     Furthermore, it may be possible to implant implant  100  with wing  120  over one part of a leaflet, and to perform an edge-to-edge repair (e.g., by implanting a leaflet clip that holds edges of the leaflet together). This edge-to-edge repair can be done at another portion of the leaflet not covered by the implant, or in some applications, may be able to be performed over or through a portion of the implant  100 . 
     Reference is made to  FIGS.  74 - 75   , which are schematic illustrations of implant  100  having been implanted at a location different to that shown above, in accordance with some applications. 
     In  FIGS.  68 A-G  and  71 , interface  110  is anchored to annulus  11  which, vis-à-vis valve  10 , is more lateral than the root  13  of the leaflet (in this case, leaflet  12 ). In contrast, in  FIG.  74   , interface  110  has been anchored medially from the root of the leaflet, with tissue-engaging element  34  of anchor  30  penetrating entirely through the leaflet and into the wall  9  of ventricle  8 . This pins, to ventricular wall  9 , the part of the leaflet that is closest to root  13 , thereby in effect reducing the effective length of the leaflet. It is hypothesized that, in addition to the advantages of implant  100  described hereinabove, such an anchoring site may be particularly useful in cases of leaflet prolapse. 
     Typically, for applications in which this anchoring site is used, prior to anchoring interface  110  is pressed against the leaflet such that the leaflet becomes sandwiched between delivery tool  50  (e.g., shaft  60  thereof) and the wall of ventricle  8 . 
     In  FIGS.  68 A-G  and  71 , implant  100  thereof is shown as being implanted medially on leaflet  12  (e.g., at the P2 scallop). In contrast, in  FIG.  75   , implant  100  has been implanted further laterally on the leaflet, e.g., close to or at a commissure  15  of valve  10 . It is hypothesized that the flexibility of wing  120  allows it to conform to the anatomy while still improving coaptation. Moreover, it is further hypothesized that this flexibility and conformation may themselves make implant  100  particularly suitable for implantation at such sites, e.g., compared with a more rigid implant that may inhibit the first leaflet from moving toward, and from coapting with, the opposing leaflet. In the example shown, implant  100  has been implanted at a location and in an orientation in which wing  120  deflects asymmetrically, facilitating coaptation, at commissure  15 , between the P3 scallop of leaflet  12  and the A3 scallop of leaflet  14 . For such applications, the two-loop structure of wing  120  may facilitate such asymmetric deflection, e.g., allowing the wing to fold along a central longitudinal axis of the wing (on which the cross-section indicated by indicators A in  FIG.  67 A  lies). 
     Reference is made to  FIG.  76   , which is a schematic illustration of an implant  100   d , in accordance with some applications. Implant  100   d  is a variant of implant  100 , and can be the same as or similar to implant  100  as described hereinabove, mutatis mutandis, except that implant  100   d  is anchored by multiple anchors. In some applications, Implant  100   d  can comprise multiple discrete anchor receivers  150 , or multiple anchors may be received by a single anchor receiver or interface. 
     In some applications, and as shown, implant  100   d  can have a single anchor receiver  150 , which receives a single anchor  30 , with additional anchors  30   a  being driven through sheet  126  in a vicinity of interface  110 . For some applications, implant  100   d  comprises multiple interfaces  110 , each of which can comprise an anchor receiver. For some applications, implant  100   d  (e.g., an anchor interface thereof) is configured to receive multiple anchors at different angular dispositions, e.g., such that the multiple anchors cooperate to provide improved anchoring. 
     Having one anchoring point provides the benefit of easier and quicker implantation, making it very easy to position the device, confirm proper functioning (e.g., using fluoroscopy and/or echocardiography), and simply anchor in place. Having multiple anchors and anchor connection points may allow for greater stability and redundancy ensuring the implant is safely and permanently secured in place. Where multiple anchor connection points and anchors are used, a delivery device can be use that is configured to delivery multiple (e.g., 2, 3, 4, etc.) anchors simultaneously to help provide greater stability and redundancy while maintaining a quick an easy delivery. 
     Reference is made to  FIGS.  77 A-B , which are schematic illustrations of an implant  100   e , in accordance with some applications. Implant  100   e  is a variant of implant  100 , and can be identical to implant  100  as described hereinabove, mutatis mutandis, except that it comprises a wing  120   e , which is a variant of wing  120 . Contact face  122   e  of wing  120   e  (corresponding to contact face  122  of wing  120 ) defines protrusions (e.g., cilia or bumps)  160  and/or recesses (e.g., dimples or pockets)  162  that are configured to capture blood cells and cell fragments, and/or to induce tissue growth and/or mild inflammation that locally thickens the underlying leaflet—this is represented by reference numeral  17 . It is hypothesized that this thickening further facilitates reduction of regurgitation, e.g., by increasing local rigidity and/or the reach of the underlying leaflet, thereby improving coaptation with the opposing leaflet. 
     As shown, the protrusions and/or recesses can be defined by sheet  126   e , e.g., by the sheet being textured. For some applications, the protrusions and/or recesses can be defined by discrete elements that are attached to the sheet. 
     Reference is now made to  FIGS.  78 A-B  and  79 , which are schematic illustrations of an anchor  30   b  and an anchor  30   c , in accordance with some applications. Anchors  30   b  and  30   c  can be used in place of any of the other anchors described hereinabove, mutatis mutandis. For some applications, anchors  30   b  and  30   c  can be considered variants of anchor  30 . Moreover, features of anchors  30   b  and  30   c  can be combined with each other, and/or with features of other anchors described herein. 
     Whereas anchor  30  has a single helical tissue-engaging element  34 , each of anchors  30   b  and  30   c  has two tissue-engaging elements, arranged as a double helix, each of the tissue-engaging elements having a sharpened distal tip. Anchor  30   b  comprises two tissue-engaging elements  34   b  (i.e., a first tissue-engaging element  34   b ′ and a second tissue-engaging element  34   b ″), and anchor  30   c  comprises two tissue-engaging elements  34   c  (i.e., a first tissue-engaging element  34   c ′ and a second tissue-engaging element  34   c ″). 
     It is hypothesized that such use of two tissue-engaging elements may provide greater stability during initial penetration of the anchor into the tissue, and/or greater anchoring strength. 
     Although anchors  30   b  and  30   c  are shown with both tissue-engaging elements having the same length, for some applications one tissue-engaging element can be longer than the other, e.g., such that one penetrates the tissue first, providing stability as the other is penetrated into the tissue. 
     For some applications, and as shown, each of the tissue-engaging elements is defined by a respective wire. This is indicated for anchor  30   b  as wire  36   b , with a first wire  36   b ′ defining tissue-engaging element  34   b ′, and a second wire  36   b ″ defining tissue-engaging element  34   b″.    
     For some applications, anchor  30   b  or  30   c  can comprise a discrete component  32   b  that serves as an anchor head and/or the part of the anchor that is engaged by the anchor driver. Component  32   b  is shown in  FIGS.  78 A-B  as a bar that traverses across a central longitudinal axis of the anchor, between wires  36   b ′ and  36   b ″. For some applications, anchor  30   b  or  30   c  can comprise a single wire that defines (i) both tissue-engaging elements, and (ii) an anchor head  32   c  and/or the part of the anchor that is engaged by the anchor driver. This is shown in  FIG.  79   . Other anchor head designs are also possible. 
     Anchor  30   b  has a tissue-engaging region  38  and a head region  39 . For some applications, and as shown, (i) in tissue-engaging region  38 , each wire  36   b  defines its respective tissue-engaging element, and has a tissue-engaging pitch d 1  that is such that, within the double helix, turns of each wire are axially spaced apart from turns of the other wire, whereas (ii) in head region  39  each wire  36   b  has a head pitch d 2  that is such that, within the double helix, turns of the first wire abut turns of the second wire. 
     For some applications, pitch d 1  facilitates screwing of tissue-engaging region  38  into tissue, whereas pitch d 2  configures head region  39  to resist being screwed into the tissue, e.g., such that head region  39  serves as an anchor head. 
     As shown for anchor  30   c , tissue-engaging elements  34   c  can, individually and/or collectively, be shaped as a conic helix that widens toward the distal end of the anchor. For some applications, such tissue-engaging elements are delivered in a radially compressed state, and expand to become conical (or more conical) during deployment. 
     While the above description contains many specific embodiments of the invention, these should not be construed as limitations on the scope of the invention, but rather as an example of one embodiment thereof. Accordingly, the scope of the invention should be determined not by the embodiments illustrated, but by the appended claims and their equivalents. Features of one embodiment can be combined with the features of other embodiments herein. In particular, features of a given variant of implant  100  can be combined with features of another variation of implant  100 , mutatis mutandis.