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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Transcatheter mitral valve replacement (TMVR) device for treating mitral valve diseases like mitral regurgitation (MR) in patients with a double-orifice mitral valve. The device has two replacement heart valves that can be delivered through a catheter to replace the existing valves in the double-orifice configuration. This allows TMVR in patients with double-orifice mitral valves who may not have been suitable for edge-to-edge repair due to anatomy. The device can be delivered through a catheter inserted over guide wires or enclosed in a sheath. It enables treating residual MR or mitral stenosis after edge-to-edge repair by replacing the valves without requiring a new surgical edge-to-edge procedure.

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A transcatheter prosthetic mitral valve and delivery system for minimally invasive treatment of mitral valve insufficiency and stenosis. The prosthetic valve has a collapsible wire frame with a stent part and a mesh part that complement each other. The frame has features for conformation and anchoring. The leaflets are made of natural or synthetic materials that can switch between open and closed positions. The delivery system can access the mitral valve retrograde from the left ventricle or antegrade from the left atrium. The delivery system captures and immobilizes the native valve leaflets during deployment to stabilize the prosthetic valve at the ventricular level. The frame provides optimal apposition, sealing, and stabilization at the annulus and atrial floor.

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Transcatheter prosthetic valve for replacing a native tricuspid valve that can be delivered through small catheters to treat tricuspid regurgitation without open-heart surgery. The valve has a unique shape and anchor features to securely attach and seal against the native valve anatomy. It can be compressed into a low profile for delivery and then expand and anchor in place. The valve has flaps that extend into the right ventricle and atrium, and arms that contact adjacent structures like the inferior vena cava and right atrium appendage. This provides robust fixation and sealing to prevent migration and leakage.

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A transcatheter valve replacement system for implanting a new heart valve without open-heart surgery. The system involves a ventricular assist device that can be connected to a docking station near the native valve. The assist device is powered by an implanted subcutaneous power supply. The valve replacement includes a stent frame and prosthetic valve connected to the docking station. This allows the valve replacement to be delivered and deployed transcatheterly. The ventricular assist device provides temporary support while the patient heals before releasing the docking station and removing the assist device.

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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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Minimally invasive mitral valve replacement prosthesis and delivery system that enables less invasive implantation compared to open heart surgery. The prosthetic valve has a radially compressible main body that expands after implantation to capture the native mitral valve leaflets. The main body has ventricular and atrial anchors that expand away during delivery to increase gaps for leaflet capture. The valve can be delivered through a catheter, expanded in the mitral annulus, and contracted for easier catheter retrieval. The leaflet-receiving spaces between the anchors and main body expand during delivery to accommodate the native leaflets, then contract to capture them. The prosthetic valve reduces the need for radial friction forces against the native annulus since the anchors secure it.

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Transcatheter mitral valve replacement system with a prosthetic half-valve that attaches directly to the native mitral valve annulus to prevent displacement and regurgitation. The prosthetic half-valve has a stent with an atrial portion to anchor the valve and a ventricular portion to displace the diseased leaflet. Dual guide and fixation (DGF) members with compressible legs secure the stent to the annulus. The prosthetic leaflets attach to the stent and skirt. The half-valve design allows for compact delivery, improved anchoring, and reduced paravalvular leakage compared to full-size prostheses.

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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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Transcatheter heart valve replacement that improves commissural alignment in patients undergoing transcatheter valve replacement procedures. The replacement includes determining a native heart valve commissural orientation according to one or more images acquired via a cardiac imaging modality; and crimping the prosthetic heart valve according to the native heart valve orientation.

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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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Tools and methods for modifying the leaflets of existing heart valves during implantation of a prosthetic heart valve to prevent obstruction of blood flow to coronary arteries. The tools are delivered through the ascending aorta and puncture, cut, nick, tear or otherwise modify the leaflets of the native or prior prosthetic valve. This allows the new prosthetic valve to expand properly without impinging on the coronary ostia.

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Docking devices and prosthetic valves for treating heart valve problems like mitral regurgitation that have circular cross-sections to better match the non-circular native annulus shapes. The docking devices expand to create a more circular anchoring site for the prosthetic valve. They also constrict the native valve anatomy to reduce leakage. The docking devices have features like foam, woven textures, and radiopaque markers to optimize retention, tissue ingrowth, and imaging. Delivery systems have separate push and sleeve shafts to advance the docking devices without increasing outer diameter.

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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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