Transfemoral and Transapical Delivery of Prosthetic Heart Valves: Techniques and Innovations

A flexible, collapsible heart valve adapter that allows compact delivery, precise implantation, and retrievability of replacement heart valves. The adapter secures and manages the position of the new valve in the native valve annulus. It has collapsible anchors and flanges that can be retracted to remove the adapter if needed. This enables replacing a failing valve years after implantation without damaging surrounding tissue. The adapter also has a receiver to hold the new valve. The collapsible design allows lower profile delivery and easier implantation compared to rigid frames.

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A transcatheter heart valve replacement that can be delivered through a catheter and implanted without open heart surgery. The valve has an asymmetric wire frame with angled flanges, a collapsible flow control sleeve, and folding tabs with anchors to secure the valve in place. The asymmetric frame design allows compact delivery and expansion. The collapsible sleeve reduces calcification. The anchors engage annular tissue. The valve can be compressed to fit within a 22-34Fr catheter diameter.

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Delivery system and method for implanting prosthetic heart valves like mitral valves that allow controlled expansion and securing inside the native valve to prevent trauma and leakage. The system uses a nested delivery catheter with a compacted prosthetic valve inside. It has a tether to radially restrain the valve during delivery. The catheter is retracted to allow the valve to expand inside an outer cover. The tether prevents valve movement until the catheter is fully retracted. This prevents contact with tissue as the valve expands. The valve has anchors that flip directions during expansion to secure the valve in place.

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Delivery system for implanting prosthetic valves, like pulmonary valves, that allows better control and maneuverability during implantation. The system has a handle, a first shaft, a second shaft, and a gripper. The second shaft connects to the gripper and can slide inside the first shaft. The gripper and second shaft move together relative to the handle and first shaft. This allows the prosthetic valve, mounted on the second shaft, to be advanced and retracted independently of the handle. It also enables compacting the delivery system for insertion through narrow vasculature. The handle may have locking mechanisms to secure the shafts during implantation. The gripper and second shaft can be symmetrically positioned relative to the handle bottom.

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Catheter for minimally invasive implantation of heart valves using self-expanding anchoring systems. The catheter has a curved shape to navigate the aorta with a small radius of curvature. This allows the catheter to negotiate the bend in the aorta without damaging the vessel wall. The curved catheter reduces the risk of complications during insertion compared to a straight catheter. The self-expanding anchoring system helps ensure accurate placement and secure anchoring of the prosthetic heart valve. The curved catheter shape improves safety during the initial insertion phase of the procedure.

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Transcatheter valve delivery system for recapturing partially deployed prosthetic heart valves during implantation. The system has a delivery catheter with a funnel-shaped device to capture and compress the valve brim if it protrudes during retrieval. This prevents the valve from expanding and catching in the vasculature during removal. The funnel inverts the valve brim over the capsule and collapses it to recapture the entire valve. This allows complete retrieval if necessary.

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Delivery system and method for implanting prosthetic heart valves using a delivery catheter that can flex and contort to navigate complex anatomies. The system has a bendable catheter tip that can be manipulated to steer the prosthetic valve through tortuous pathways. The catheter tip has an inner shaft that can flex independently of an outer shaft. This allows the tip to bend in different directions to conform to the body anatomy. The valve is secured on the catheter with tethers that can be released to detach the valve once it reaches the implantation site. The catheter can also have a handle with a gear system to translate the inner shaft axially to expose or cover the valve tethers. This enables controlled deployment of the valve without trauma to the native valve tissue.

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Delivery device for minimally invasive implantation of transcatheter heart valves. The device allows compact delivery of the valve prosthesis components through narrow blood vessel access points. It has a proximal sheath to enclose the anchoring component and a distal carrier assembly with enclosures for the valve frame. The frame and anchor are loaded serially to reduce profile. The anchor can be expanded independently, then the frame is expanded and released. A plunger biases the frame out. This allows precise positioning of the anchor before expanding the frame.

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A delivery system for a transcatheter heart valve that can consistently deliver the valve with aligned commissures for easier coronary reaccess after valve replacement. The system has a catheter housing the valve, an elongated member with an accessory for aligning the valve commissures during delivery, and a rotational member to rotate the accessory and valve together. The accessory has components based on the native or prosthetic valve anatomy to align the new valve commissures with the existing ones. This reduces the risk of obstruction or interference with coronary arteries after valve implantation.

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Loading assembly for collapsible prosthetic heart valves into minimally invasive delivery devices that reduces the risk of damage during loading and allows easy loading of valves with dual cuffs. The loading assembly has a support member with a recess to hold the collapsed valve. The recess has an inlet port and multiple outlet ports. Fluid is injected through the inlet to deair the valve and force the cuffs together. This prevents edges catching on the delivery device during loading. The valve is then pushed into the device while deaired, reducing the risk of damage.

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Delivery devices for transcatheter heart valve implantation that use adjustable sutures to compress and expand the valve during delivery. The devices allow precise control of valve compression for navigating through the body and releasing the valve at the implant site. The sutures wrap around the valve and can be tightened or loosened to adjust compression. This allows delivering a compact valve through small vessels and then expanding it at the implant site.

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Valve holder and introducer systems for minimally invasive implantation of prosthetic heart valves like mitral valves. The valve holder has a piston that pulls in the commissures to prevent suture looping during implantation. Activating the holder by attaching a handle prevents implantation without engagement. The holder and valve can deform for delivery through small incisions. An introducer helps collapse the profile. The valve has a superelastic wireform and band for high flexibility.

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Delivery system for transfemoral delivery of collapsible prosthetic heart valves that can be re-collapsed if necessary. The delivery system has a flexible catheter with a reinforced tubular member made of helically wound metal strands. The strands are joined together and/or coated with polymer to prevent sliding and maintain dimensional stability under load. This allows safe transmission of high forces to re-collapse the valve if needed. The re-expandable valve can be partially collapsed if repositioning or removal is required.

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Delivery system for implanting prosthetic heart valves that enables easier insertion into the heart and secure anchoring. The system has a telescoping configuration with multiple adjustable flexure radii. It uses a heart valve capsule that can be collapsed and extended to fit inside smaller vessels. The capsule is attached to the distal end of the first catheter. The heart valve is loaded inside the capsule and released at the implant site. The system allows independent adjustment of flexure radii in the catheters, relative axial movement, and capsule rotation. This allows maneuvering the valve to the implant site and securing it without protruding excessively into the heart chambers.

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A delivery system for collapsible prosthetic heart valves that enables more precise and flexible implantation, especially in cases where the apex entry point and annulus alignment are misaligned. The system has an articulating joint that allows the sheath to pivot transversely to the longitudinal axis. This allows the valve to be repositioned while collapsed. A restrictive sheath can lock the joint in place when extended longitudinally. This prevents accidental pivoting during delivery. The restrictive sheath retracts to release the joint for pivoting. This allows the valve to be repositioned mid-delivery to better align with the annulus.

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Heart valve delivery system that enables controlled expansion of a self-expanding prosthetic heart valve from a delivery sheath to prevent jumping and ensure precise deployment. The system has a delivery catheter with a sheath that slides relative to the catheter to advance the valve. This prevents uncontrolled expansion from the valve's inherent outward force. A retaining mechanism keeps the valve connected to the catheter after deployment. It can be a fork system or sutures that allow adjustment before releasing the valve.

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