Transapical method of delivering prosthetic heart valve
First Claim
1. A method of implanting a prosthetic heart valve in an aortic valve annulus of a patient while the patient'"'"'s heart remains beating, comprising:
- accessing a left ventricle through an intercostal incision;
forming a puncture in the left ventricle;
introducing a guidewire through the puncture and into the left ventricle;
advancing the guidewire through a native aortic valve;
passing an introducer sheath over the guidewire and through the puncture into the left ventricle, the introducer sheath having a lumen extending therethrough, the introducer sheath including a proximal housing containing a valve assembly for preventing bleeding from the lumen;
inserting a valve delivery device over the guidewire, through the valve assembly and through the lumen of the introducer sheath, the valve delivery device having a prosthetic heart valve mounted thereon a deflecting segment located just proximal to the prosthetic heart valve and a pusher having a distal sleeve mounted over the deflecting segment;
advancing the valve delivery device over the guidewire until the prosthetic heart valve is located in the aortic valve annulus;
using the pusher and sleeve to advance the prosthetic heart valve;
proximally displacing the pusher and sleeve with respect to the deflecting segment and then bending the deflecting segment from a proximal handle to facilitate positioning the prosthetic heart valve in the aortic valve annulus; and
then expanding the prosthetic heart valve in the aortic valve annulus, wherein the step of expanding the prosthetic heart valve in the aortic valve annulus comprises expanding the prosthetic heart valve in a prosthetic heart valve previously implanted within the native aortic valve annulus.
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Accused Products
Abstract
A method of delivering a prosthetic heart valve to the aortic valve annulus while a patient'"'"'s heart is beating. The method includes accessing the left ventricle through an intercostal incision and forming a puncture in the left ventricle. A guidewire is advanced into the left ventricle and through the native aortic valve. An introducer sheath is passed over the guidewire and into the left ventricle. A prosthetic heart valve is advanced over the guidewire and through the introducer sheath using a delivery catheter. After positioning the prosthetic heart valve in the native aortic valve, the prosthetic heart valve is radially expanded in the aortic valve annulus for replacing the function of the native aortic valve.
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Citations
17 Claims
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1. A method of implanting a prosthetic heart valve in an aortic valve annulus of a patient while the patient'"'"'s heart remains beating, comprising:
- accessing a left ventricle through an intercostal incision;
forming a puncture in the left ventricle;
introducing a guidewire through the puncture and into the left ventricle;
advancing the guidewire through a native aortic valve;
passing an introducer sheath over the guidewire and through the puncture into the left ventricle, the introducer sheath having a lumen extending therethrough, the introducer sheath including a proximal housing containing a valve assembly for preventing bleeding from the lumen;
inserting a valve delivery device over the guidewire, through the valve assembly and through the lumen of the introducer sheath, the valve delivery device having a prosthetic heart valve mounted thereon a deflecting segment located just proximal to the prosthetic heart valve and a pusher having a distal sleeve mounted over the deflecting segment;
advancing the valve delivery device over the guidewire until the prosthetic heart valve is located in the aortic valve annulus;
using the pusher and sleeve to advance the prosthetic heart valve;
proximally displacing the pusher and sleeve with respect to the deflecting segment and then bending the deflecting segment from a proximal handle to facilitate positioning the prosthetic heart valve in the aortic valve annulus; and
then expanding the prosthetic heart valve in the aortic valve annulus, wherein the step of expanding the prosthetic heart valve in the aortic valve annulus comprises expanding the prosthetic heart valve in a prosthetic heart valve previously implanted within the native aortic valve annulus. - View Dependent Claims (2, 3, 4, 5, 6)
- accessing a left ventricle through an intercostal incision;
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7. An off-pump method of implanting a prosthetic heart valve in an aortic valve annulus of a patient while the patient'"'"'s heart is beating, comprising:
- threading one or more purse-string sutures in a circular pattern through tissue of the left ventricle;
forming a puncture in the wall of the left ventricle within the circular pattern of the one or more purse-string sutures;
introducing a guidewire through the puncture and into the left ventricle;
advancing the guidewire through an aortic valve annulus;
while maintaining tension on the one or more purse-string sutures, advancing a dilator over the guidewire and through the puncture into the left ventricle;
while maintaining tension on the one or more purse-string sutures, passing an introducer sheath over the dilator, through the puncture and into the left ventricle, the introducer sheath having a lumen extending therethrough;
removing the dilator from within the introducer sheath;
advancing a valve delivery device over the guidewire, through the valve assembly of an introducer housing and through the lumen of the introducer sheath, the valve delivery device having a prosthetic heart valve mounted thereon a deflecting segment located just proximal to the prosthetic heart valve and a pusher having a distal sleeve mounted over the deflecting segment;
advancing the valve delivery device and prosthetic heart valve over the guidewire until the prosthetic heart valve is positioned in the aortic valve annulus;
using the pusher and sleeve to advance the prosthetic heart valve;
proximally displacing the pusher and sleeve with respect to the deflecting segment and then bending the deflecting segment from a proximal handle to facilitate positioning the prosthetic heart valve in the aortic valve annulus; and
then expanding the prosthetic heart valve in the aortic valve annulus, wherein the step of expanding the prosthetic heart valve in the aortic valve annulus comprises expanding the heart valve in a prosthetic heart valve previously implanted in the aortic valve annulus. - View Dependent Claims (8, 9, 10, 11, 12)
- threading one or more purse-string sutures in a circular pattern through tissue of the left ventricle;
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13. An off-pump method of implanting a prosthetic heart valve in an aortic valve annulus of a patient while the patient'"'"'s heart is beating, comprising:
- providing a delivery catheter having a distal end portion and an expandable prosthetic heart valve mounted on the distal end portion, the delivery catheter also having a deflecting segment located just proximal to the prosthetic heart valve and a pusher having a distal sleeve mounted over the deflecting segment;
creating an intercostal access opening and exposing an apex of a left ventricle;
creating a puncture at or near the apex of the left ventricle;
inserting an introducer sheath through the puncture;
passing the delivery catheter through the introducer sheath and into the left ventricle;
using the pusher and sleeve to advance the delivery catheter such that the prosthetic heart valve is positioned in the aortic valve annulus;
proximally displacing the pusher and sleeve with respect to the deflecting segment and then bending the deflecting segment from a proximal handle to facilitate positioning the prosthetic heart valve in the aortic valve annulus; and
then expanding the prosthetic heart valve in the aortic valve annulus for replacing the function of a native aortic valve, wherein the step of expanding the prosthetic heart valve in the aortic valve annulus comprises expanding the prosthetic heart valve within a previously implanted prosthetic heart valve. - View Dependent Claims (14, 15, 16, 17)
- providing a delivery catheter having a distal end portion and an expandable prosthetic heart valve mounted on the distal end portion, the delivery catheter also having a deflecting segment located just proximal to the prosthetic heart valve and a pusher having a distal sleeve mounted over the deflecting segment;
Specification