This application relates to methods, systems, and apparatus for replacing native heart valves with prosthetic heart valves and treating valvular insufficiency. In a representative embodiment, a support frame configured to be implanted in a heart valve comprises a main body formed by formed by a plurality of inner members forming an inner clover and a plurality of outer members forming an outer clover. The support frame can include gaps located between inner members of the plurality of inner members and outer members of the plurality of outer members. The inner clover can be radially inside the outer clover, and the outer clover can have larger dimensions than the inner clover. The support frames herein can be radially expandable and collapsible.

Methods and systems for rotationally aligning a commissure of a prosthetic heart valve with a commissure of a native valve are disclosed. In some examples, a delivery apparatus can include a first shaft configured to rotate around a central longitudinal axis of the delivery apparatus to rotationally align a prosthetic valve mounted on the delivery apparatus with native anatomy, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end portion of the first shaft, an inflatable balloon coupled to the distal end portion of the first shaft, and a distal shoulder mounted on the distal end portion of the second shaft and arranged within a distal end portion of the balloon. The distal shoulder comprises a base portion and a flared portion that extends radially outward from the base portion, and a radiopaque marker is disposed on the flared portion.

A stent includes a first longitudinally extended cylinder having a C-shaped cross-section and a second longitudinally extended cylinder having a C-shaped cross-section. The first cylinder includes a plurality of first longitudinal struts and an array of first radial struts extending between the first longitudinal struts. The second cylinder includes a plurality of second longitudinal struts and an array of second radial struts extending between the second longitudinal struts. The first cylinder and the second cylinder are configured to form a dense mesh structure when assembled. When assembled, the second cylinder may be disposed in the first cylinder. The first cylinder may overlap with the second cylinder to form the dense mesh structure.

Rolling tractor tube mechanical thrombectomy apparatuses that may be deployed from out of a catheter in situ are described herein. These apparatuses may be delivered out of a catheter from a collapsed delivery configuration within the catheter to a deployed configuration out of the catheter, in which the same catheter is re-inserted between a tubular tractor and an elongate puller. In particular, any of these methods and apparatuses may be adapted to work with a tractor tube having an open end that is biased open, including using an annular bias.

A stent 10 includes corrugated pattern bodies 11 and connection elements 12. A corrugated pattern is formed of corrugated units 14, corrugated unit 14 including a first stem 15, a second stem 16, a third stem 17, a first top portion 18 coupling a first end portion 15a of the first stem 15 and a first end portion 16a of the second stem 16, and a second top portion 19 coupling a second end portion 16b of the second stem 16 and a first end portion 17a of the third stem 17. A second end portion 17b of the third stem 17 is connected to a second end portion 15b of the first stem 15 in another corrugated unit adjacent to corrugated unit. A first end portion 12a of connection element 12 is connected to the first top portion 18 of one of adjacent ones of the corrugated units 14, and a second end portion 12b of connection element 12 is connected to the second end portion 15b of the other one of the adjacent ones of the corrugated units 14.

An endoprosthesis may include an expandable framework including an anchoring portion and a body portion extending axially from the anchoring portion, the body portion having a plurality of body cells; and a polymeric cover disposed on at least a portion of the expandable framework. The anchoring portion includes a first transverse flange and a second transverse flange proximate the first transverse flange, the first and second transverse flanges being configured to secure the anchoring portion at an orifice of a body lumen. The body portion includes a window through a side of the body portion, the window occupying space equivalent to at least two of the plurality of body cells. The window is devoid of the polymeric cover and any other structure within a perimeter of the window.

Medical devices and methods are provided. In some aspects, devices useful for applying therapy locally within a body vessel are disclosed, the devices having a stent graft with flared end regions with a catheter providing fluid communication to the outer side of the narrower, intermediate region of the stent graft. Kits and systems including the same devices and methods are also disclosed.

According to various aspects and embodiments, a growth adaptive expandable stent is provided. The expandable stent includes a stent structure having a cylindrical shape that is self-expanding in a radial direction and includes a plurality of cylindrical rings disposed along a longitudinal axis of the stent structure. The stent structure is configured to exert a continuous outward radial force over time when implanted such that a diameter of the stent structure expands from a first value to a second value that is at least about 1.5 times the first value.

An eustachian tube (ET) drug eluting stent includes a plurality of longitudinal spars with spring-like elements between each of the plurality of longitudinal spars, creating smooth arcs between each of the plurality of longitudinal spars while minimizing impediment of mucociliary flow. The combination of the plurality of longitudinal spars with spring-like elements are configured to enter into the ET uncompressed.

A prosthetic mitral valve includes an anchor assembly, an annular strut frame, and a plurality of replacement leaflets secured to the annular strut frame. The anchor assembly includes a ventricular anchor, an atrial anchor, and a central portion therebetween. The annular strut frame is disposed radially within the anchor assembly. An atrial end of the annular strut frame is attached to the anchor assembly such that a ventricular end of the annular strut frame is spaced away from the anchor assembly.