Valve-in-Valve Procedures for Improved Cardiac Care

Prosthetic heart valves that can be accurately positioned within existing implanted valves using percutaneous techniques. The valves have radiopaque markers that can be visualized outside the body to identify valve size, position, and depth after implantation. The markers aid in optimal placement, reducing the risk of coronary artery obstruction and enabling multiple valve stacking if needed.

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A delivery system for percutaneous implantation of a prosthetic heart valve. The system allows controlled and precise deployment of a self-expanding valve from a sheath using rotational movement instead of push-pull forces that can cause uncontrolled valve jumping. The valve is connected to a torque shaft catheter that can be rotated to unsheathe and expand the valve in a controlled manner. The system also has releasable mechanisms to disconnect the valve from the catheter after deployment.

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Prosthetic heart valve designed to be implanted in less time than current devices. It uses a two-stage design where a tissue anchoring member is first deployed to secure the native valve annulus, followed by the attachment of the valve member to the anchoring member. This allows for faster implantation compared to sewing in a valve. The anchoring member can be expanded to anchor quickly in place. The valve member can then be attached to the anchoring member.

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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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A percutaneous, transcatheter deployment system for mitral valves. The system has multiple catheters that can engage each other and releasably couple to the prosthetic mitral valve components. A deployment frame with clamps allows simultaneous movement of the catheters to position and release the valve components.

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Simplified prosthetic heart valves that can be expanded after implantation to accommodate larger expandable prosthetic heart valves for valve-in-valve procedures. The expansion capability is achieved by incorporating two wireform frames, an upper one and a lower one, that can stretch apart slightly upon application of an outward dilatory force. The lower wireform has a shallow undulation that prevents excessive expansion. The upper wireform has inflow cusps and commissure posts while the lower wireform has truncated peaks between them. The wireforms permit limited expansion of the valve diameter upon dilation to receive a larger valve inside.

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Prosthetic heart valve that can be moved to an inverted configuration for delivery of the prosthetic valve to within a patient's heart. The prosthetic valve includes an outer frame that can be inverted relative to an inner frame when the prosthetic valve is in a biased expanded configuration. This allows the valve to be collapsed for delivery in a sheath, then expanded in the heart.

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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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A collapsible prosthetic heart valve designed for implanting in aortic valve replacement procedures that has improved performance and reduced regurgitation compared to conventional valves. The valve has a stent with a unique cuff shape and extended landing zone that helps position the valve supra-annularly in the native aortic valve. This allows the prosthetic leaflets to fully open above the compressed native leaflets, reducing regurgitation and improving blood flow. The cuff also positions the valve stent deeper in the aortic annulus to anchor it.

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Prosthetic heart valve designed to be expandable from within in order to receive a replacement prosthetic valve. The valve has a structure that can be dilated using a balloon catheter, allowing it to expand to a larger diameter. This enables a second replacement valve to later be implanted inside. The expandable valve has a composite support ring with flexible segments that can stretch when dilated. This allows it to transform from a rigid configuration to an expanded configuration to accommodate the replacement valve.

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A prosthetic heart valve that can be collapsed to a smaller diameter for delivery and then expanded to a larger diameter after implantation. The valve has a stent frame and a valve support that can invert within the stent frame. When inverted, the two structures overlap to reduce the overall diameter. This allows the valve to be compressed to a smaller size for delivery through a catheter, then expanded to full size after implantation.

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Delivery system for expandable heart valves that enables controlled and precise deployment of the valve using a catheter-based mechanism. The system includes movable deployment members that engage the valve to regulate its self-expansion rate as it opens after deployment. This allows gradual expansion of the valve as desired rather than sudden or uneven expansion that could damage tissue. The system also has means for expanding the valve further if needed.

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