A transcatheter valve prosthesis including a tubular stent includes an interior skirt or skirt portion is coupled to and covers an inner circumferential surface of the stent, and an exterior skirt or skirt portion is coupled to and covers an outer circumferential surface of the stent. A prosthetic valve component is disposed within and secured to the interior skirt or skirt portion. The interior and exterior skirts or skirt portions may overlap to form a double layer of skirt material on the stent, or may be portions of a skirt that do not overlap such that only a single layer of skirt material covers the stent. When the stent is in at least the compressed configuration, at least one endmost crown may be positioned radially inwards with respect to the remaining endmost crowns formed at the inflow end of the stent in order to accommodate the exterior skirt.

A stent (300, 400, 400′) for a prosthetic heart valve includes a body having an inflow end (310, 410) and an outflow end (312, 412), and an anchoring section (340, 440) adjacent the inflow end. The anchoring section may include structure (342, 344, 420) that extends radially outwardly from the body when the stent is in an expanded condition. The stent may include a transition section (370, 470) between the body and the anchoring section, the transition section in the expanded condition of the stent having a diameter that is smaller than the diameters of the body and the anchoring section. When implanted into a native valve annulus, such as the mitral valve annulus, the anchoring section may help the stent resist migrating away from the native valve annulus.

Apparatus for repairing a heart valve and methods for implanting anchors and repairing a heart valve are provided. The apparatus comprises a body, a member attached to the body at a first end and having a plurality of positioning cords spaced laterally across the member and extending away from a second end of the member opposed to the first end, a tube suspended from the plurality of positioning cords, and an adjustment cord extending through the tube. The method comprises implanting at least one annular anchor in a mitral annulus of the heart valve, implanting a papillary anchor through each papillary muscle of the heart, delivering and positioning an apparatus for repairing a heart valve inside the heart valve using the at least one annular anchor and the papillary anchors, and adjusting the apparatus to adjust the extent of atrial displacement of the heart's mitral leaflets during ventricular contraction.

Apparatus and methods are provided including a mitral valve prosthesis. The prosthesis includes an inner support structure having downstream and upstream sections, the upstream section having a cross-sectional area greater than the downstream section. The inner support structure is configured to be positioned on an atrial side of the native valve complex, and to prevent the prosthesis from being dislodged into the left ventricle. A prosthetic valve having prosthetic valve leaflets is coupled to the inner support structure. An outer support structure has engagement arms, downstream ends of the engagement arms being coupled to the inner support structure. The prosthesis is configured such that, upon implantation thereof: downstream ends of the native valve leaflets, downstream ends of the engagement arms, and downstream ends of the prosthetic leaflets,

are disposed at a longitudinal distance from one another of less than 3 mm. Other embodiments are also described.

A method for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased valve.

A transcatheter valve prosthesis includes an expandable tubular stent, a prosthetic valve within the stent, and an anti-paravalvular leakage component coupled to and encircling the tubular stent. The anti-paravalvular leakage component includes a radially-compressible annular scaffold, which is a sinusoidal patterned ring of self-expanding material, and an impermeable membrane extending over the annular scaffold. The anti-paravalvular leakage component has an expanded configuration in which at least segments of the annular scaffold curve radially away from the tubular stent. Alternatively, the anti-paravalvular leakage component includes a plurality of self-expanding segments and an annular sealing element coupled to inner surfaces of the segments. The anti-paravalvular leakage component has an expanded configuration in which the segments curve radially away from the tubular stent and the annular sealing element is positioned between an outer surface of the tubular stent and inner surfaces of the segments. The segments may be orthogonal or oblique to the outer surface of the tubular stent.

Single filter and multi-filter endolumenal methods and systems for filtering fluids within the body. In some embodiments a blood filtering system captures and removes particulates dislodged or generated during a surgical procedure and circulating in a patient's vasculature. In some embodiments a filter system protects the cerebral vasculature during a cardiac valve repair or replacement procedure.

A method of deploying an implantable stented device in an anatomical location of a patient, including the steps of providing a delivery system with first and second stent engagement structures at its distal end, attaching a first structural element of the stented device to the first stent engagement structure and attaching a second structural element of the stented device to the second silent engagement structure, advancing the stented device to an implantation site, and sequentially disengaging the first structural element of the stented device from the first stent engagement structure of the delivery system and then disengaging the second structural element of the stented device from the second stent engagement structure.

A gravity sensitive silicone breast implant is provided which, in various embodiments, has a soft, natural feel and adapts shape after implantation responsive to gravity, according to movements of the patient.

A prosthetic heart valve (e.g., a prosthetic aortic valve) is designed to be somewhat circumferentially collapsible and then re-expandable. The collapsed condition may be used for less invasive delivery of the valve into a patient. When the valve reaches the implant site in the patient, it re-expands to normal operating size, and also to engage surrounding tissue of the patient. The valve includes a stent portion and a ring portion that is substantially concentric with the stent portion but downstream from the stent portion in the direction of blood flow through the implanted valve. When the valve is implanted, the stent portion engages the patient's tissue at or near the native valve annulus, while the ring portion engages tissue downstream from the native valve site (e.g., the aorta).