A delivery system for prosthetic heart valves are provided. The delivery system includes a flexible shaft, a distal sheath capsule configured to contain the prosthetic heart valve, an inner steerable catheter including an inner distal flex component, and an outer steerable catheter including an outer distal flex component. The inner distal flex component includes a first cut pattern and a second cut pattern distal to the first cut pattern. The outer distal flex component includes a third cut pattern. The inner steerable catheter is rotatable at least 90 degrees relative to the outer steerable catheter when the third cut pattern of the outer distal flex component is disposed over at least a portion of the first cut pattern of the inner distal flex component and each of the inner steerable catheter and the outer steerable catheter is in the flexed configuration.

A medical implant including an expandable framework configured to shift between a collapsed configuration and an expanded configuration, the expandable framework comprising a plurality of interconnected struts defining a plurality of cells; and an occlusive element connected to the expandable framework and having an inner surface and an outer surface. The expandable framework may include a plurality of securement members projecting from the plurality of interconnected struts. One of the inner surface or the outer surface of the occlusive element may be in contact with the plurality of interconnected struts, and the other of the inner surface and the outer surface not in contact with the plurality of interconnected struts may lie against an opposing surface of each of the plurality of securement members. A tip portion of the plurality of securement members may not extend radially outward of the plurality of interconnected struts.

A delivery system for delivering a heart valve prosthesis includes a heart valve prosthesis and a delivery catheter. The heart valve prosthesis includes an anchoring member and an inner valve support, and further includes a radially collapsed configuration and a radially expanded configuration. The delivery catheter includes a handle, an outer shaft, an intermediate shaft, an inner shaft, and a distal tip component. The delivery catheter further includes a delivery configuration. In the delivery configuration, the outer shaft of the delivery catheter is configured to retain a first portion of the anchoring member, the intermediate shaft is configured to retain a first portion of the inner valve support, and the distal tip component is configured to retain a second end of the anchoring member and a second end of the inner valve support each in a radially compressed state.

Apparatus for endovascularly replacing a patient's heart valve, including: a replacement valve adapted to be delivered endovascularly to a vicinity of the heart valve; an expandable anchor adapted to be delivered endovascularly to the vicinity of the heart valve; and a lock mechanism configured to maintain a minimum amount of anchor expansion. The invention also includes a method for endovascularly replacing a patient's heart valve. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve; expanding the anchor to a deployed configuration; and locking the anchor in the deployed configuration.

An implantable prosthetic valve includes a radially collapsible and expandable annular frame having three commissure attachment posts and four rows of circumferential struts. The rows include a first row, a second row downstream of the first row, a third row downstream of the second row, and a fourth row downstream of the third row and defining an outflow end of the frame. Each row of circumferential struts includes angled struts arranged in a zig-zag pattern. A leaflet structure includes three leaflets forming three commissures, each commissure being connected to one of the commissure attachment posts only at locations along the commissure attachment posts between a first plane that is perpendicular to a longitudinal axis of the frame and intersects crowns of the third row of struts and a second plane that is perpendicular to the longitudinal axis and intersects crowns of the fourth row of struts.

Disclosed herein are representative embodiments of methods, apparatus, and systems used to deliver a prosthetic heart valve assembly. In embodiments, a prosthetic heart valve assembly, including a self-expandable support structure and a self-expanding heart valve, are advanced through the aortic arch of a patient using a delivery system. The support structure, which includes a plurality leaflet retaining arms, is at least partially expanded and positioned on or adjacent to the outflow side of the aortic valve. The prosthetic heart valve is positioned in the aortic valve. The prosthetic heart valve is expanded while it is within an interior of the support structure and while the support structure is positioned on or adjacent to the outflow side of the aortic valve, thereby causing one or more native leaflets of the aortic valve to be frictionally secured between the arms of the support structure and the expanded prosthetic heart valve.

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, 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 third shaft surrounding the first shaft. The first shaft is configured to rotate within the third shaft and translate axially relative to the third shaft, and the third shaft includes a distal tip portion including a plurality of internal helical expansion grooves and a plurality of external helical expansion grooves that are configured to allow the distal tip portion to flex radially outward.

A valve prosthesis (10), comprising a stent (1), a leaflet (2), and a skirt (3); the stent (1) comprises an inflow end, an outflow end, and a plurality of wavy segments axially connected; the wavy segments comprise a plurality of reticular structure units disposed circumferentially; the leaflet (2) and the skirt (3) are fixed on the stent (1) respectively; the upper portion of the skirt (3) is provided with indentations (321); the skirt (3) is fixed with the leaflet (2) by means of the indentations (321); the skirt (3) further comprises first protrusion portions (323) extending toward the direction of the outflow end of the stent; one ends of the first protrusion portions (323) are connected with the indentations (321), and the other ends of the first protrusion portions are fixed to the stent (1); by such a way, the connection strength of the skirt (3) and the stent (1) is enhanced; and besides, when the valve prosthesis (10) is implanted at a lower position, perivalvular leakage preventing height can be increased by means of the first protrusion portions (323), thereby avoiding the leakage of a part of blood from the stent (1) and further improving the perivalvular leakage preventing effect.

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.

Vascular remodeling devices can include a proximal section, an intermediate section, and a distal section. During deployment, the proximal section can expand from a compressed delivery state to an expanded state and anchor the device in an afferent vessel of a bifurcation. The distal section expands from the compressed delivery state to an expanded state that may be substantially planar, approximately semi-spherical, umbrella shaped, or reverse umbrella shaped. The distal section is positioned in a bifurcation junction across the neck of an aneurysm or within an aneurysm. The intermediate section allows perfusion to efferent vessels. Before or after the device is in position, embolic material may be used to treat the aneurysm. The distal section can act as a scaffolding to prevent herniation of the embolic material. The device can be used for clot retrieval with integral distal embolic protection.