Valve-in-Valve Implantation for Heart Valve Replacement

Delivery systems for prosthetic heart valves and methods to deliver and deploy them in the body. The systems have features like compactable tethers, retention mechanisms, and controllable deflection to facilitate implantation through narrow access points. The prosthetic valves themselves have features like expandable frames, retention tethers, and disintegration assemblies to aid implantation and securement. The delivery systems also have features like deflection actuators, pull tethers, and spacer bodies to enable controlled deployment in complex anatomies.

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A transcatheter valve prosthesis and implantation method to replace a native heart valve like the mitral or tricuspid valve. The prosthesis has a tubular body with a prosthetic valve and a fabric covering. It's delivered catheterically to the native valve location. Instead of removing the native valve, the prosthesis partially deploys to engage the native leaflets. Then it's fully deployed to lift the native leaflets and avoid obstruction. This allows natural blood flow through the ventricle. The fabric-covered tubular body replaces valve function without obstructing.

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Implanting a prosthetic valve within a native valve for replacing a calcified native heart valve. The prosthetic valve includes a support structure for deployment on an upstream side of the native valve and including an atrial anchor forming a ring about the flow channel.

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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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Safe and controlled replacement of heart valves using expandable prosthetic valves that can be precisely delivered and secured in place. The method involves expanding the prosthetic valve inside a support structure positioned on the native valve. This frictionally secures the leaflets between the support and prosthetic valves. The support structure can be delivered separately or as part of the prosthetic valve delivery catheter. The support structure is expandable and can have features like peaks that align with native valve leaflet tips to facilitate securement. This prevents the prosthetic valve from ejecting quickly and allows precise positioning. It also prevents further valve dilatation. The support structure is later disconnected from the delivery catheter once secured.

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A replacement heart valve system that enables compact delivery and customizable expansion while anchoring securely to the native valve tissue. The system uses a collapsible adapter that attaches to the native valve and provides a sealing portion. The replacement valve itself is a flexible frame optimized for sealing and fixation. The adapter and replacement valve can be delivered separately or together. The adaptive frame allows compact delivery via catheters and expands to fit the heart. The adapter anchors supra-annularly, sub-annularly, and radially. The replacement valve can be removed and replaced. The system aims to improve heart valve intervention outcomes by allowing retrievability, directional flow, and native valve compatibility.

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A expandable prosthetic heart valve designed to securely anchor in a native mitral valve annulus without impeding blood flow to the left ventricular outflow tract. The valve has an inner stent, valve assembly, outer stent, and tether. The outer stent folds into a double-walled flange that engages the atrial surface of the native annulus. A sealing cuff on the flange prevents leaks. The tether anchors the valve to the heart wall. This allows the valve to expand without extending into the ventricle. The folded flange reduces profile for delivery.

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A prosthetic mitral valve system for reducing regurgitation and avoiding obstruction issues when implanted without removing the native valve. The system has separate expandable anchor and valve components that engage the native mitral valve. A containment member on the anchor restricts anterior leaflet movement to prevent it from obstructing the outflow tract. This prevents the leaflet from being pulled into the outflow tract by pressure differential during systole, which can cause obstruction. The containment member can be angled beyond the leaflet to further prevent retraction. The separate expandable components allow independent positioning and adjustment for optimal mitral valve replacement without obstructing the outflow tract.

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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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A compact, easy-to-handle percutaneous valve delivery system for implanting prosthetic heart valves through minimally invasive procedures. The system uses a balloon expandable prosthetic valve mounted on a single balloon with differential inflation. The balloon has a distal section, middle section, and proximal section. Inflation starts with the distal section, then the middle section, and finally the proximal section. This staged inflation allows precise placement and retrievability of the valve across the native valve annulus. The compact design avoids obstruction of the coronary arteries and simplifies handling compared to conventional two-balloon systems.

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Interventional artificial heart valve that reduces blood regurgitation and mitigates complications compared to existing devices. The valve has a collapsible stent with artificial leaflets, covered by a blood-absorbing annular seal. The seal expands after absorbing blood to secure the valve in place. The stent also has connecting elements to attach an anchoring section that fixes the valve. The anchoring section has elasticity and attaches to the native valve annulus. This improves stability and reduces leakage compared to prior devices that just compress and expand the valve stent.

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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 transcatheter heart valve replacement with adjustable regurgitation control. The valve has a compressible frame that allows delivery through a small catheter. It has inner and outer flow control components, with the outer component having a compressible wire cell. The frame can be compressed for delivery and expands in place. The wire cell allows backflow adjustment by cutting an opening in the tissue cover. This allows intentional regurgitation to match native valve function. The valve can be delivered orthogonally through major blood vessels.

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A method for replacing native heart valves with prosthetic valves that can be used to treat conditions like aortic insufficiency where the native valve has soft leaflets that can't securely anchor a balloon-expandable prosthetic valve. The method involves delivering a support structure like a stent or band to the native valve location and expanding it. Then, a prosthetic valve is delivered into the support structure and expanded to secure the native leaflets between them. This allows the prosthetic valve to be accurately positioned and anchored without compressing the native valve. The support structure is later disconnected from the delivery catheter.

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A prosthetic heart valve assembly that aims to reduce complications and improve outcomes from heart valve replacement procedures. The assembly has a unique prosthetic heart valve design that closely matches the size and shape of a native valve. This reduces obstruction of blood flow and avoids issues like conduction disturbances and coronary occlusions. The assembly also uses a specialized dispensing catheter with features like uniform radial expansion and linear valve positioning to prevent embolization and occlusions. The goal is to provide a more accurate, efficient, and safer replacement heart valve implantation procedure.

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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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Minimally invasive method and device for delivering and expanding prosthetic heart valves through the vasculature without fully occluding the lumen during expansion. The device has an expandable frame with movable distal and proximal ends that can be configured to separate and then join together. When the ends are separated, the frame expands radially outwards to deliver and expand the prosthetic valve without fully occluding the lumen. This reduces blockage during implantation compared to expanding a balloon to deliver the valve.

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A blood flow controlling apparatus for treating leaking heart valves without open heart surgery. The device has a valve that can extend into the heart to block regurgitation, and an anchoring element to fix it in place. The valve contacts tissue when inserted but releases when exposed to blood flow. This allows implantation through small puncture sites by separating the valve and anchoring diameters. The valve extends transversely to engage the valve leaflets or vessel wall, preventing backflow. The anchoring element secures the position. The device can be delivered using a catheter and implanted without stopping the heart.

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A prosthetic heart valve design that allows precise and repeatable placement during minimally invasive procedures. The valve has a radiopaque element around the base that can be easily identified using X-rays to accurately position the valve inside the heart. This helps avoid issues like misplacement or regurgitation that can occur with conventional valves. The valve also has commissure posts and a stent structure that allow multiple valves to be stacked on top of each other for repeat implantation in the same location. The radiopaque base enables visual confirmation of valve stacking depth.

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