An assembly includes an implant body and a delivery apparatus. The implant body includes a lattice structure, an adjustment member, and a control device. The lattice structure is circumferentially expandable and contractible. The adjustment member and the control device are coupled to the lattice structure. Actuating the adjustment member results in circumferential expansion or contraction of the lattice structure. The delivery apparatus includes a rotatable adjustment tool and a locking mechanism comprising a controllable catch coupled to an end portion of the rotatable adjustment tool. The rotatable adjustment tool is configured to actuate the adjustment member of the implant body upon rotation of the rotatable adjustment tool. The controllable catch of the locking mechanism is configured to selectively couple the rotatable adjustment tool to the adjustment member of the implant body.

A stent delivery system includes a handling device having a housing, a rotatable thumbwheel, and a winding spool. A catheter arrangement includes an inner shaft fixed on the housing. An outer sheath is disposed coaxially to the inner shaft. At least one stent is received radially between the inner shaft and the outer sheath. A flexible pull member engages on the outer sheath and is held on the winding spool to be windable. To release the at least the one stent, the outer sheath is displaceable relative to the inner shaft by winding the flexible pull member on the winding spool. A deflecting and tensioning device is spaced from the winding spool in the proximal direction, is in operative connection to the flexible pull member, and is used to deflect the flexible pull member in a direction towards the winding spool and to tension the flexible pull member.

An expandable stent for implantation in a right ventricular outflow tract includes a frame having a plurality of struts that define a repeating pattern of cells. The repeating pattern of cells comprises a column of exactly three generally diamond shaped cells positioned in end-to-end alignment, and a column of exactly two generally diamond shaped cells positioned in end-to-end alignment. The frame has a substantially hourglass shape with a narrow portion in between a proximal end portion and a distal end portion, wherein the proximal end portion and the distal end portion are configured to expand radially outward to contact a right ventricular outflow tract.

The active introducer sheath systems disclosed herein are expanded by activating a translation mechanism at the handle. The sheath has an inner cylindrical structure of comingled fixed and mobile elongate rods bound together by an attachment line. Activating the translation mechanism causes the mobile rods to move axially with respect to the fixed rods, changing the internal tension in the attachment line. Increased tension draws the fixed and mobile rods closer together, decreasing the diameter of the cylindrical structure. Decreased tension in the attachment line enables the fixed and mobile rods to move apart, increasing the diameter of the cylindrical structure. A prosthetic device, such as a prosthetic heart valve, can be routed through the expanded sheath and to the implantation site. During implantation, the sheath can be contracted back to its original outer diameter, and expanded again for retrieval of the delivery apparatus.

An implant delivery device includes a holder, a guide rod, and a sliding handle. One end of the guide rod is connected to the holder, and the other end of the guide rod penetrates the sliding handle. Multiple first engagement structures axially spaced apart from each other are disposed on an outer surface of the guide rod. The delivery device also includes a position locking device disposed in the sliding handle. The position locking device includes a tooth block) and an elastic component. The tooth block is sleeved on the guide rod and is provided with a second engagement structure. The elastic component and the tooth block cooperate to allow the first engagement structures and the second engagement structure to engage with each other allowing an implant to be in a release-locked state. These and other elements allow for the implant to be gradually released or release-locked.

A system for delivering an implantable medical device includes a handle housing. An outer sheath is coupler secured to a proximal end of an outer sheath that is configured to cover at least a portion of the implantable medical device. An outer sheath drive assembly is operably coupled to the outer sheath coupler and is configured to translate the outer sheath relative to the handle housing. An actuation shaft coupler is secured to a proximal end of an activation shaft. An actuation shaft drive assembly is operably coupled to the actuation shaft coupler and is configured to cause the actuation shaft to translate relative to the handle housing and shift the implantable medical device from a first position and a second position in which the implantable medical device is radially expanded relative to the first position.

Modular pre-loaded implant subassemblies that can be packaged separately from a handle, which allows using any one of a plurality of separately packaged modular pre-loaded implants with a common handle.

A method for implanting a prosthesis centrally within a curved lumen includes loading a prosthesis into a delivery sheath, advancing the sheath in a patient towards the curved lumen to place at least the proximal end of the prosthesis within the curved lumen, and centering the proximal end of the prosthesis and/or the distal end of the sheath within the curved lumen. In a first advancing step, the outer catheter containing the inner sheath is advanced together towards the curved lumen to a location proximal of the curved lumen and, in a second advancing step, the inner sheath containing the prosthesis is advanced into the curved lumen to place at least the proximal end within the curved lumen while the outer catheter substantially remains at the location. After centering, the proximal end of the prosthesis is deployed centered within the curved lumen.

A stent delivery system includes a handling device having a housing, a thumbwheel rotatably mounted in the housing, and a winding spool rotating with the thumbwheel. A catheter arrangement includes an inner shaft fixed on the housing. An outer sheath is coaxial to the inner shaft. A stent is received between the inner shaft and outer sheath. A pull member engages the outer sheath and is held on the winding spool to be windable. For release of the stent, the outer sheath is displaceable by winding the pull member on the winding spool. A locking mechanism causes, upon reaching at least one defined angle of rotation of the thumbwheel, a locking state of the rotational mobility of the thumbwheel, and thereby of the proximal displaceability of the outer sheath. An unlocking mechanism is in operative connection to the locking mechanism. The locking state is reversible with the unlocking mechanism.

An assembly and associated method for a commissure of a prosthetic heart valve is disclosed. As one example, a method includes forming each of a plurality of commissures with a plurality of leaflets by pairing a first commissure tab of a first leaflet with an adjacent, second commissure tab of a second leaflet, folding a support strip over an inner reinforcing element, positioning the folded support strip between the first and second commissure tabs, and attaching first and second outer reinforcing elements to the first and second commissure tabs, respectively, via stitching, the stitching extending over at least a portion of the first reinforcing element opposite a fold region of the support strip, and, for each commissure, securing end portions of the support strip to a respective support portion of a frame of the prosthetic heart valve.