Major Innovations in Minimally Invasive Heart Valve Implantation Techniques

A simplified hybrid prosthetic heart valve design for easier assembly and reduced labor hours that facilitates valve-in-valve deployment and reduces manufacturing complexity. The valve has an expandable frame at the inflow end that can be compressed for delivery. The expandable frame can plastically expand when subjected to sufficient force, allowing post-implant expansion. This avoids the need for an overall expandable frame. The inflow stent provides anchoring while allowing valve-in-valve. The outflow stent is compressible to reduce size during delivery.

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A collapsible prosthetic heart valve that can be collapsed for minimally invasive delivery and expands after implantation. The valve has a collapsible stent with a downstream ring connected by flexible struts near the commissures. This prevents the leaflets from contacting the ring. The stent has a serpentine outflow edge with inner and outer rings. The ring has small connections to the outer ring, allowing leaflets to be inserted between them. This configuration reduces impingement, paravalvular leakage, and leaflet abrasion compared to prior designs.

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A medical device for repairing aortic insufficiency by reducing the diameter of the aortic valve annulus. It involves a percutaneously implantable annular support structure that can be expanded and positioned below the aortic valve to engage the leaflets and reduce the effective annulus diameter. This improves valve closure to prevent regurgitation. The support structure may also be overexpanded to radially constrict the annulus for long term reduction.

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Catheter system for transvascular implantation of prosthetic heart valves with self-expanding anchoring systems that can be implanted with minimal invasion and reduced risk to the patient. The catheter has a flexible, bendable distal section that allows it to navigate through the aorta without damaging the vessel walls. It also has a mechanism to retract the valve into the catheter if it is improperly positioned for repositioning rather than attempting to remove it.

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Percutaneously implantable prosthetic heart valves that can be deployed through minimally invasive procedures. The valves use collapsible stents with docking structures that allow percutaneous delivery and expansion in the heart. The stents have flexible wires and posts that can be compressed for delivery on catheters, then expanded and rotated into position. Valves are attached to the stents with features to distribute stress for durability. The delivery systems allow retrieval and repositioning of partially deployed valves.

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Method of assembling prosthetic heart valves with improved leaflet attachment using buckle clamps. The assembly method involves pre-assembling the leaflets by wrapping their tabs around buckle clamps. The preassembled leaflet/clamp units are then attached to the valve frame. This improves attachment compared to directly suturing leaflet tabs to the frame.

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A mitral valve replacement system that can be delivered and repositioned in a controlled manner using inverted deployable anchors. The valve prosthesis has expandable feet at the end of its frame, which can pivot from an inverted position to an expanded position upon release. The delivery instrument can collapse the anchors to the inverted position for crossing the native valve annulus, then extend them once past the annulus to anchor the valve subannularly. This controlled anchor deployment allows repositioning the valve if needed. The pivotable inverted anchors ensure secure attachment without damaging heart tissue.

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A collapsible prosthetic heart valve for replacing a mitral valve in the heart. The valve has a collapsible stent, a valve assembly, a flange and coupling tubes. The stent has a collapsed condition for delivery and an expanded condition for implantation. The valve assembly is inside the stent. The flange has braided wires and a flared portion. The coupling tubes connect the flange to the stent.

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A prosthetic heart valve with a frame, valve structure, and actuator that expands and contracts the frame. The actuator has an axially movable portion coupled to the frame and a rotatable locking element. It allows controlled expansion/contraction of the valve, then locks it in a desired size. The actuator configuration offers precise adjustment and secure fixation of the frame versus using separate expandable/lockable mechanisms.

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Prosthetic heart valve with visible indicator for post-implant monitoring and replacement. The valve has a radiopaque marker visible on imaging that provides information such as valve size, expandability, make, and model. This allows tracking implanted valve characteristics without medical records. The marker can be on components like the sealing ring or frame that are visible from outside the body. The visible indicator allows selecting compatible replacement valves and performing valve-in-valve procedures using transcatheter valves. The marker can be made from radiopaque material or have openings filled with radiopaque material.

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A catheter-based system for retrieving and repositioning transcatheter prosthetic mitral valves from inside the heart. The system involves using a specialized catheter assembly to capture, collapse, and remove a previously implanted mitral valve through a transseptal approach. This enables percutaneous retrieval and repositioning of the mitral valve without open heart surgery. The catheter assembly has multiple catheters and a snare to invert and collapse the valve for retrieval through the catheter lumen.

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Percutaneous transcatheter valve replacement for dysfunctional heart valves like the mitral, tricuspid, and aortic valves. The method involves using a specially designed prosthetic valve that can be everted to a compressed pre-deployment configuration to fit inside a catheter, then expanded to a deployed configuration once positioned at the valve annulus. The expanded valve is secured in place with tethers that pierce the surrounding tissue. This allows precise positioning and secure attachment without sutures or adhesives.

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Percutaneously implantable prosthetic mitral valve designed for secure fixation in the native mitral valve anatomy, ease of deployment and ability to be repositioned. The valve has separate anchor and valve components that can be deployed independently. The anchor expands to engage sub-annular tissue and stabilize the valve, while the valve attaches to the anchor and replaces the native valve function. The valve and anchor can be separately mounted to a delivery catheter system.

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An expandable introducer sheath for minimally invasive delivery of medical implants like prosthetic heart valves. The sheath can temporarily expand and contract to accommodate larger devices while minimizing vessel trauma during insertion. The sheath has alternating sections of stiff material and elastic material that allows expansion without buckling. The expandable sheath can also have reinforcing layers like braided fibers or a stent for added strength. The variable stiffness of the alternating sections enables temporary diameter expansion to fit the implant and then returning to the original profile after passage. This provides a minimally invasive delivery system that reduces vessel tearing and plaque dislodgement compared to fixed diameter sheaths.

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Enhanced cardiac imaging and navigation for transcatheter heart valve procedures. The technique involves using a small electrophysiological 3D mapping catheter to create a detailed 3D map of the heart. This map is displayed in real-time during the procedure along with other imaging modalities like echocardiography or fluoroscopy. The combined imaging provides enhanced visualization for accurate positioning and deployment of transcatheter heart valves.

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