A skirt-reinforcement member for supporting or reinforcing an unsupported portion of a skirt that spans across a side opening of a stent or frame of a valve prosthesis. The skirt-reinforcement member is configured to prevent billowing of the skirt material that spans across the side opening of the inner frame of the valve prosthesis, as such billowing may undesirably result in contact between the skirt and leaflets of the valve prosthesis after the valve prosthesis is deployed in situ.

A rod (508) is transfemorally advanceable to the heart. An implant (460) comprises (i) a first frame (462), compressed around a first longitudinal site of a distal portion of the rod, (ii) a second frame (464), compressed around a third longitudinal site of the distal portion, (iii) a valve member (50), disposed within the second frame, and (iv) a flexible sheet (466), coupling the first frame to the second frame, and disposed around a second longitudinal site of the distal portion, the second longitudinal site being between the first longitudinal site and the third longitudinal site. An extracorporeal controller (569) is coupled to a proximal portion of the rod, and is operably coupled to the distal portion of the rod. Operating the controller bends the distal portion of the rod causing articulation between the frames. Other embodiments are also described.

A method and system provide and use a patellar implant. The patellar implant includes a superior portion, an inferior portion opposite to the superior portion, and an anterior portion. The superior portion being configured to reside below a patellar tendon and to elevate and/or tilt the patellar tendon. The inferior portion is configured to be seated in proximity to a tibia. The anterior portion is between the superior portion and the inferior portion. The anterior portion is placed in proximity to a patella. In one aspect, the method includes inserting the implant beneath the patellar tendon and between the patella and a position at which the patellar tendon is affixed to the tibia. In this aspect, the method also includes affixing the implant.

A delivery assembly includes a prosthetic device, a catheter shaft, a release wire, a first line, and a second line. The prosthetic device has a first arm and a second arm. The release wire extends through the catheter shaft. The first line includes a first loop. The first line extends from the catheter shaft, through the first arm of the prosthetic device, and to the release wire, where the release wire extends through the first loop. The second line includes a second loop. The second line extends from the catheter shaft, through the second arm of the prosthetic device, and to the release wire, where the release wire extends through the second loop.

A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.

A heart valve assembly includes an inner frame comprising a graft covering housing a prosthetic heart valve, wherein the graft covering extends around the prosthetic heart valve for providing sealing to the heart valve, an outer frame formed from a metallic material and defining a gridded configuration, and being secured to the graft covering by a plurality of stitches, and a sealing material positioned externally to the outer frame for providing sealing between the outer frame and a patient's anatomical wall to prevent paravalvular leaks. The sealing material includes a plurality of radially extending fibers that extend outwardly of the outer frame. The graft covering is made of polyester, polytetrafluoroethylene, expanded polytetrafluoroethylene, or a polymer.

The present disclosure relates to the field of endoscopy. Specifically, the present disclosure relates to systems and methods which allow the distal portion of a catheter to be visualized within the body using a colored marker and one or more secondary markers. In particular, the present disclosure relates to systems and methods which indicate when a medical device is properly positioned for deployment within a body lumen.

A valve stent and a valve prosthesis. The valve stent is in the shape of a mesh tube, and has a compressed state and an expanded state. The valve stent includes an inflow tract structure, a transition tract structure, an outflow tract structure, and a barb structure. The transition tract structure has a fifth end portion, a sixth end portion, and a first middle section. In the expanded state, the diameters of the radial sections of the fifth end portion and the sixth end portion are greater than the diameter of the radial section of the first middle section of the transition tract structure. The outflow tract structure has a seventh end portion and an eighth end portion. The seventh end portion of the outflow tract structure is fixedly connected to the sixth end portion of the transition tract structure, and the eighth end portion is a free end. The barb structure is disposed on the transition tract structure and the outflow tract structure, and protrudes towards the outside of the transition tract structure and/or the outflow tract structure. The valve stent and the valve prosthesis can be stably anchored on natural valves.

Prosthetic heart valves described herein can be deployed using a transcatheter delivery system and technique to interface and anchor in cooperation with the anatomical structures of a native heart valve. In some embodiments, composite two-portion prosthetic heart valves in which two expandable components are attached to each other can be arranged in a nested configuration during both the transcatheter delivery process and the deployment process within the heart. Deployment systems and methods for using the deployment systems described herein facilitate implanting the composite two-portion prosthetic heart valves that are attached and arranged in a nested configuration during the transcatheter delivery and deployment processes.

Apparatus and methods are described including implanting an aortic pressure-loss-reduction device (20) in a subject's ascending aorta. While the device is inside a catheter (42), a distal end of the catheter is placed within the ascending aorta. A proximal covering sheath (44) of the catheter is retracted such as to uncover at least a portion of a downstream anchor (31), such that the uncovered portion of the downstream anchor includes a portion of the frame that does not have material coupled thereto. Subsequently, a distal covering sheath (45) of the catheter is advanced, such as to cause an upstream anchor (33) to anchor an upstream end device (20) to the subject's ascending aorta, by the upstream anchor radially expending against an inner wall of the ascending aorta. Other applications are also described.