A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient's heart, where the anchoring device can better secure a prosthesis at the native annulus. A sheath catheter may be utilized to deliver the delivery catheter and a catheter for deploying a prosthetic valve to the anchoring device.

A delivery apparatus for an expandable prosthetic heart valve includes a handle, and a shaft having a proximal end portion coupled to the handle and a distal end portion including a delivery capsule. The delivery capsule having an inner surface, an outer surface, and a plurality of elongate and axially extending inner and outer guide rails, the inner guide rails being spaced apart circumferentially around and extending radially inwardly from the inner surface and the outer guide rails being spaced apart circumferentially around and extending radially outwardly from the outer surface. The inner guide rails are configured to engage the prosthetic heart valve in a radially-compressed configuration and the outer guide rails are configured to contact an inner surface of an outer shaft.

A flexible delivery catheter comprising an outer jacket, a coil layer, and a braided layer where the coil layer is disposed within the inner lumen of the braided layer, and the braided layer is disposed between the outer jacket and the coil layer. The coil layer is wound to resist axial compression and tension applied to the delivery catheter; the coil layer facilitates bending of the delivery catheter in a direction away from the longitudinal axis of the delivery catheter. The coil layer and the braided layer are provided along a distal tip portion of the delivery catheter, the distal tip portion extending along a length of the delivery catheter from a distal end of the delivery catheter toward the proximal end of the delivery catheter.

The expandable sheaths disclosed herein are adapted to be used in tortuous vessels, such as, but not limited to, the subclavian artery. The sheaths are expandable to facilitate passage of a medical device through a central lumen of the sheath. The sheaths can be used to deliver medical devices, such as implantable heart valves. The methods of delivering a medical device can include transforming a distal region of the expandable sheath to an at least partially bowed configuration and bending a central shaft of the expandable sheath around a bend in vasculature without kinking the sheath.

The present invention discloses a core assembly, a sheath assembly, a sheath, a sheath processing method and an interventional instrument delivery system and method. A core assembly for delivering an interventional instrument according to the present invention comprises a core tube, a locking member fixed at a distal end of the core tube for connecting the interventional instrument, and a bendable adjustable tube mounted around an outer periphery of the core tube, wherein the distal ends of the bendable adjustable tube and the core tube are fixedly connected to each other, and the proximal ends can slide relative to each other.

Distal tips for use with delivery catheters are disclosed that are configured to facilitate deflection of the catheters as they are advanced through the vasculature to a desired treatment site. Distal tips so configured realize one or more of the objectives of safer, more accurate steering of the catheter through the vasculature.

A reinforced cardiovascular sheath and wire assembly includes an inner tube with an external surface extending between a proximal end and a distal end. A reinforcement braid is in contact with the external surface of the inner tube. A wire with a distal segment is interwoven into, and in contact with, the reinforcement braid. A proximal segment of the wire extends proximally from the proximal end of the inner tube out of contact with the reinforcement braid. An outer tube receives, and is in contact with, the reinforcement braid and the inner tube. A vascular intervention device delivery system utilizes the sheath/wire assembly as a retractable sheath and pull wire.

A delivery device includes a handle, a sheath distally extending from the handle, a capsule distally extending from the sheath, and a pull wire having a proximal end attached to the handle and a distal end attached to the capsule. The sheath defines a central lumen there-through and has a longitudinally-extending lumen formed within a wall of the sheath. The capsule has a tubular body with an intermediate region having a plurality of ribs and a plurality of slots defined therein. The capsule includes an indented segment defined on the tubular body, the indented segment being disposed radially inward relative to the tubular body. The pull wire is tensioned to bend the capsule. The pull wire is slidably disposed within the longitudinally-extending lumen of the sheath and along an inner surface of the tubular body of the capsule with a portion of the pull wire crossing over an outer surface of the indented segment.

An expandable sheath including an elongated inner member defining a central lumen extending therethrough. The inner member includes a first circumferential portion including a first and second longitudinal edges, and a second circumferential portion extending between the first and second longitudinal edges. The wall thickness of the first circumferential portion is greater than the wall thickness of the second circumferential portion. The elongated inner member is configured to transition from an unexpanded configuration to an expanded configuration in response to a radially outward force on an inner surface of the central lumen. In the unexpanded configuration, the elongated inner member is creased proximate the first and second longitudinal edges into a folded configuration such that the second circumferential portion is positioned at least partially radially inward of the first circumferential portion.

A percutaneous bypass method for implanting a bypass graft between two vessels is described. The bypass graft comprises a first part and a second part, each having a tubular shape and comprising respective lumens. The method comprises the step of inserting a second sheath, from the outside to the inside of a bypass portion of the first part, through a puncture therein, and retracting the second sheath so as to deploy and implant a hook portion of the second part into the second vessel, and deploy a bypass portion of the second part outside the second vessel, from the second vessel to the first part, and within the lumen of the first part.