Transcatheter Delivery of Prosthetic Heart Valves: Innovations and Techniques

A prosthetic heart valve that can be delivered through less invasive percutaneous techniques by compressing or folding the valve during delivery then transitioning it to an expanded operating configuration once in place. The valve has a stent, leaflets, and a flexible sleeve connecting them. The valve can transform from a delivery configuration with the leaflets outside the stent to an operating configuration with the leaflets inside the stent by pushing the leaflets into the stent as the sleeve inverts. This allows a smaller delivery profile. The valve can be anchored by outward force on the native valve annulus when expanded.

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Prosthetic heart valve with reinforced, variable thickness leaflets that improve durability and reduce delivery profile compared to conventional tissue leaflets. The leaflets have a skeleton reinforcement material to enhance strength and resistance to tearing. The leaflets also have a thickness that decreases from the belly edge to the free edge. This allows the leaflet to better withstand stresses near the belly while reducing collapsed volume for delivery.

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Prosthetic heart valve that can be compressed and expanded for transcatheter delivery. The valve has distal, proximal, and septal subannular anchoring elements to secure it in a native valve annulus. The septal element extends below the annulus to stabilize the valve against rotation. This anchoring configuration allows the valve to be side-loaded into a catheter for delivery, instead of fully compressing it radially. It is released from the catheter to expand and anchor in the annulus. The septal element pinning the native leaflet prevents dislodgement.

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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 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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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 delivery catheter for implantable medical devices with improved flexibility and lower profile for navigating through tortuous anatomy. The catheter has a braided shaft with an axial spine between inner and outer braid layers. The spine provides axial rigidity for push/pull forces, while the braided layers provide flexibility. The distal end has a capsule that can be actuated to expose the device. The capsule has a flexible region with delaminated jacket for increased flexibility. The lower profile, flexible catheter reduces trauma when delivering implants like stents and heart valves via minimally invasive procedures.

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A transcatheter prosthetic heart valve that can be side delivered through a small catheter and then expand once deployed in the heart. The valve has a compressible frame with anchoring tabs and a central flow component. The frame is compressed orthogonal to the catheter axis. After release, it expands to engage the native valve annulus. The tabs anchor the valve while the central portion allows unidirectional blood flow.

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Transcatheter delivery of a two-part prosthetic mitral valve for implantation within the native mitral valve. The valve has an anchor assembly and a nested valve assembly that expand separately. The anchor engages the native annulus while the valve seals with the leaflets. The two-part design enables smaller delivery size through catheters. The valve parts are deployed in stages, first expanding the anchor then the valve inside it.

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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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A two-step deployment method for prosthetic heart valves that allows for collapsible valves with fewer layers and a simpler design to be used. The method involves first implanting an expandable anchoring platform in the patient's heart. Then a separate expandable valve with interlocking features is deployed inside the anchored platform. The valve expands and locks into the platform to complete the implant. This sequential deployment allows for collapsible valves without multi-layer designs while still having secure anchoring.

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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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