Methods of valve delivery on a beating heart
First Claim
1. A method of deploying and implanting a prosthetic heart valve into a beating heart, comprising:
- while the heart is beating, forming an incision and passing an introducer having a stiff proximal section and a more flexible distal section terminating in a distal end into the left side of the heart such that the distal section extends within and at least 4 cm beyond a heart wall and flexes with movement of the heart muscle to lessen damage to the heart wall from a stiff introducer, wherein the introducer has a free length L with the stiff proximal section having a length of at least one half the free length L, wherein the stiff proximal section extends substantially straight out of the body so as to provide a direct-access approach lumen;
advancing a balloon catheter having a prosthetic heart valve mounted on a distal balloon through and beyond the distal end of the introducer such that the prosthetic heart valve is positioned within the existing aortic valve, the balloon catheter having a proximal control handle; and
inflating the balloon to expand the prosthetic heart valve against the existing aortic valve.
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Accused Products
Abstract
A delivery system and method for delivering a prosthetic heart valve to the aortic valve. The system includes a delivery catheter having a steering mechanism thereon for delivering a balloon-expandable prosthetic heart valve to the aortic valve through an introducer passing into the left ventricle through its apex. The introducer may have a more floppy distal section than a proximal section to reduce trauma to the heart wall while preserving good operating field stability. The delivery catheter includes a deflecting segment just proximal to a distal balloon to facilitate positioning of the prosthetic heart valve in the proper orientation. A trigger in a catheter handle may be coupled to a deflection wire that actuates the deflecting segment, while a slider in the handle controls retraction of a valve pusher. The prosthetic heart valve may be installed over the existing calcified leaflets, and a pre-dilation valvuloplasty procedure may also be utilized.
263 Citations
21 Claims
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1. A method of deploying and implanting a prosthetic heart valve into a beating heart, comprising:
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while the heart is beating, forming an incision and passing an introducer having a stiff proximal section and a more flexible distal section terminating in a distal end into the left side of the heart such that the distal section extends within and at least 4 cm beyond a heart wall and flexes with movement of the heart muscle to lessen damage to the heart wall from a stiff introducer, wherein the introducer has a free length L with the stiff proximal section having a length of at least one half the free length L, wherein the stiff proximal section extends substantially straight out of the body so as to provide a direct-access approach lumen; advancing a balloon catheter having a prosthetic heart valve mounted on a distal balloon through and beyond the distal end of the introducer such that the prosthetic heart valve is positioned within the existing aortic valve, the balloon catheter having a proximal control handle; and inflating the balloon to expand the prosthetic heart valve against the existing aortic valve. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A method of deploying and implanting a prosthetic heart valve into a beating heart, comprising:
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while the heart is beating, forming an incision and passing an introducer having a stiff proximal section and a more flexible distal section terminating in a distal end into the left side of the heart, wherein the stiff proximal section extends substantially straight out of the body and the distal section is located within the heart so as to provide a direct-access approach lumen, and wherein the introducer including a proximal hemostatic valve to help prevent blood loss therethrough; attaching a tubular loader to a proximal end of the introducer, the loader defining a throughbore and structure for snapping onto mating structure on the introducer, the loader further having a proximal housing with a vent button and a distal nose that extends from the proximal housing and opens the hemostatic valve; advancing a balloon catheter having a prosthetic heart valve mounted on a distal balloon through the loader throughbore and through and beyond the distal end of the introducer; single-handedly aspirating air from within the loader throughbore using the vent button on the proximal housing after the heart valve has been inserted into the introducer through the loader; further advancing the balloon catheter and positioning the heart valve within the existing aortic valve; and inflating the balloon to expand the prosthetic heart valve against the existing aortic valve. - View Dependent Claims (15, 16, 17, 18, 19, 20)
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21. A method of deploying and implanting a prosthetic heart valve into a beating heart, comprising:
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while the heart is beating, forming an incision and passing an introducer having a stiff proximal section and a more flexible distal section terminating in a distal end into the left side of the heart, wherein the stiff proximal section extends substantially straight out of the body and the distal section is located within the heart so as to provide a direct-access approach lumen; advancing a balloon catheter having a prosthetic heart valve mounted on a distal balloon through and beyond the distal end of the introducer such that the prosthetic heart valve is positioned within the existing aortic valve, the balloon catheter having a proximal control handle on which is mounted a deflection actuator for deflecting the balloon and the prosthetic heart valve relative to a proximal section of the catheter, further including a tubular loader defining a throughbore and structure for snapping onto a proximal end of the introducer, the loader having a distal nose that extends through and opens an introducer valve and facilitates passage therethrough of the balloon of the balloon catheter, wherein the method includes single-handedly aspirating air from within the loader throughbore using a vent button on the loader after the heart valve has been inserted into the introducer through the loader; moving the deflection actuator to deflect the balloon catheter and the prosthetic heart valve relative to the existing aortic valve; and inflating the balloon to expand the prosthetic heart valve against the existing aortic valve.
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Specification