A valve prosthesis is adapted to operate in conjunction with native heart valve leaflets. The prosthesis includes an annulus and a skirt extending from the annulus. The skirt may be configured to be positioned through a native heart valve annulus, and the skirt may be movable between an open configuration permitting blood flow through the skirt and a closed configuration blocking blood flow through the skirt in cooperation with opening and closing of the native heart valve leaflets.

A catheter system is disclosed, having a plurality of expandable arms with radiopaque markers at their ends. Once deployed at a patient's valve, a user can obtain a correct 3D localization image for placement of the replacement valve by aligning the radiopaque markers to be substantially equidistant from each other and substantially located in the same plane, relative to the sensor of an X-Ray machine.

A system includes a medical device for implanting in a valve of a subject, the implantable medical device having a self-expanding frame; and a holder configured to retain the frame of the implantable medical device in a constricted configuration and to control expansion of the frame. The holder has a controllably constrictable and expandable loop, wherein the loop is disposed about at least a portion of the self-expanding frame such that constriction or expansion of the first loop controls constriction or expansion of the frame.

Systems and methods of valve quantification are disclosed. In one embodiment, a method of mitral valve quantification is provided. The method includes generating a 3-D heart model, defining a 3-D mitral valve annulus, fitting a plane through the 3-D mitral valve annulus, measuring the distance between at least two papillary muscle heads, defining an average diameter of at least one cross section around the micro valve annulus, and determining a size of an implant to be implanted.

A device for measuring an expanded internal orifice of a patient includes an orifice- expanding device, a pressure measuring device, and a size-measuring device. The size- measuring device measures a dimension of the orifice after it has been expanded by the orifice-expanding device.

A device for measuring an internal dimension of a native cardiac valve annulus includes an elongated support member having a proximal portion and a distal portion. A measuring portion is coupled to the distal portion, and an indicator is coupled to the proximal portion of the support member. The measuring portion is biased towards a deployed configuration such that when deployed it applies an outwardly directed radial force to the native valve annulus.

Apparatus and methods are described, including a method for measuring an opening of an appendage of an atrium of a subject. A catheter is inserted into the atrium, and at least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The loop is used to measure the opening of the appendage. Other applications are also described.

A catheter for positioning a valve during a transcatheter aortic valve replacement is formed from a resilient hollow body conformable to a guide wire when a guide wire is passed in through an upper opening in the hollow body and through the hollow body. When the guide wire is retracted, the catheter deploys to form a substantially straight upper shaft portion that extends downwardly from the upper opening and a distal ring perpendicular to the upper shaft portion. The distal ring approximates the size and shape of the patient's aortic valve annulus. A lower loop connects the upper shaft portion of the catheter to the distal ring. An outer surface of the distal ring is radiopaque, and the distal ring comprises openings for dispersing radio opaque medium used in imaging of the patient's aortic valve annulus. The deployed catheter is advanced until it snugly contacts the aortic valve with the horizontal loop at the level of the aortic valve leaflets and with the lower loop dipping into one the aortic valve cusps. The distal ring will be viewed as a straight line when an x-ray C-arm is properly aligned with the aortic valve.

A system includes a medical device for implanting in a valve of a subject, the implantable medical device having a self-expanding frame; and a holder configured to retain the frame of the implantable medical device in a constricted configuration and to control expansion of the frame. The holder has a controllably constrictable and expandable loop, wherein the loop is disposed about at least a portion of the self-expanding frame such that constriction or expansion of the first loop controls constriction or expansion of the frame.

This transcatheter device for the ablation of calcified tissue at the flaps of an aortic valve, is characterised in that it comprises a flexible body (1) acting as a catheter and having a soft and flexible end piece (2) that engages with a previously inserted wire guide (g) suitable for passing through the flaps of the valve above the part where the calcified tissue needs to be removed, said end piece (2) having at least one cutting system (3) comprising two motorised rotating cutting heads (3a) and (3b) disposed coaxially one above the other, the head (3a) located at the end of the end piece and acting first to remove the calcified tissue, has arrangements suitable for making a rough cut by grinding, while the other head (3b) has arrangements suitable for making a fine cut by grinding, said cutting system being mounted in combination with a vacuum suction means (4), said end piece (2) being provided with an adjustable guide means (5) suitable for engaging with the calcified tissue over the course of the ablation operation performed by the cutting system (3) in combination with a spiral path effect applied to the end piece.