An implantable device is provided for controlling the internal circumference of an anatomic orifice or lumen. The implantable device has an adjustable member configured to adjust the dimensions of the implantable device. The implantable device is configured to be coupled to a faster that provides for fastening of said implantable device to tissue around the anatomic orifice or lumen. An adjustment tool actuates the adjustable member and provides for adjustment before, during or after the anatomic orifice or lumen resumes near normal to normal physiologic function. The adjustment member of is positioned off plane relative to the implantable device to provide that the implantable device can be adjusted on a beating heart to cause leaflet coaptation. The adjustment member is positioned to enable attachment to and adjustment of the implantable device, and detachment from the implantable device and removal from the body under normal beating heart conditions.