Among other things, a tool to attach a support to a heart valve annulus includes a stabilizing body that includes features to stabilize an axial position of the tool relative to the annulus, and an attachment device connected to the stabilizing body, the stabilizing body and the attachment device being movable relative to one another under control from a location remote from the tool. The support may have an expandable tubular body having a plurality of struts, a plurality of tissue anchors extending from distally facing apexes in a distal direction post-deployment, wherein axial distal advance of the implantable annulus support causes the plurality of tissue anchors to axially engage tissue, and the implantable annulus support is self-contractible from a radially enlarged engagement configuration for engaging tissue of the mitral valve annulus, to a reduced, deployed configuration for modifying mitral valve annulus geometry.

An insertion device that allows gaining access to the left ventricle of the heart, via the tissue forming the wall of the right ventricle and via the ventricular septum, which includes a tubular shaft with a lumen extending there through, the shaft comprising distal, proximal and central sections, whereby the distal and proximal sections are disc-shaped extended thus forming each a double disc and whereby the central section links the distally placed double disc with the proximally placed double disc and whereby pressure valves are fixed inside the shaft preferably on its distal and proximal end.

A heart valve prosthesis including a frame, the frame including a plurality of struts designed to extend from an upstream side of a natural heart valve to a downstream side of the natural heart valve, and a plurality of connectors attached to the plurality of struts, wherein the plurality of connectors are arranged as arcs connecting the struts, the arcs having two ends, each end attached to one of the struts, and a peak pointing from a center of the frame circumferentially outward and toward the upstream side of the frame, and the plurality of connectors are arranged as at least two rows, each row circumnavigating the center lumen of the frame. Related apparatus and methods are also described.

Pinch devices and access systems that can be used to secure a prosthetic heart valve to a heart valve annulus and to treat valvular insufficiency. A pinch device can be a separate expandable element from the prosthetic heart valve that is first advanced to the annulus and deployed, after which an expandable prosthetic heart valve can be advanced to within the annulus and deployed. The two elements can clamp/pinch the heart valve leaflets to hold the prosthetic heart valve in place. The pinch device can have a flexible, expandable annular frame. A combined delivery system can deliver the pinch device and prosthetic heart valve with just a single access point and aid more accurate coaxial deployment. The pinch device can be mounted near distal end of an access sheath, and a catheter for delivering the prosthetic heart valve can be passed through a lumen of the same access sheath.

A delivery system for percutaneously deploying a prosthetic heart valve. The system includes an inner shaft assembly, a delivery sheath capsule and a handle maintaining a first actuator and a second actuator. The capsule is configured to compressively retain the prosthetic heart valve over the inner shaft assembly. The first actuator is operated to proximally retract the delivery sheath capsule and expose the prosthetic heart valve relative to the capsule. The second actuator is operated to proximally retract the prosthetic heart valve by transmitting forces to the inner shaft assembly.

A device for crimping a radially expandable and collapsible prosthetic valve comprises a crimping loop having a first end portion, a second end portion, and a loop portion extending between the first and second end portions and defining an opening configured to receive the prosthetic valve. The crimping loop is movable between a first state in which the opening has a first diameter and a second state in which the opening has a second diameter smaller than the first diameter such that when the prosthetic valve is positioned within the loop portion, movement of the crimping loop from the first state to the second state is effective to reduce a diameter of the prosthetic valve. A method for crimping a prosthetic valve comprises reducing a diameter of an opening of a crimping loop, thereby radially compressing an at least partially expanded prosthetic valve disposed within the opening.

A transcatheter prosthesis with radially compressed and expanded configurations. An elongate member encircling at least a portion of the prosthesis, and configured to provide a seal between the prosthesis and a native anatomy when the prosthesis is deployed in the radially expanded configuration. The elongate member may be a resilient elongate member having a radially contracted state, when in tension, to hold at least the portion of the prosthesis in the radially compressed configuration, and having a radially expanded state, when relaxed, to provide the seal between at least the portion of the prosthesis and a native anatomy when the prosthesis is deployed. A system for delivering the transcatheter prosthesis may include a delivery catheter having an elongate cinching member encircling at least a second portion of the prosthesis, wherein the elongate cinching member is configured to hold the second portion of the prosthesis in the radially compressed configuration.

An apparatus and method of deploying a stent graft having a proximal anchor stent ring includes restraining proximal apexes of the proximal anchor stent ring between a spindle body of a spindle and a control release sleeve of a tapered tip. The control release sleeve is advanced relative to the spindle to release a first proximal apex through an opening in the control release sleeve while the remaining proximal apexes remain restrained by the control release sleeve. The control release sleeve is further advanced relative to the spindle to release the remaining proximal apexes from the control release sleeve. In another example, a stent capture fitting has variable length stent capture fitting arms. As the stent capture fitting is retracted, the proximal apexes of the proximal anchor stent ring are sequentially exposed from and released by the variable length stent capture fitting arms. By using the control release sleeve or the stent capture fitting, controlled sequential release of the proximal apexes is achieved.

The present invention is primarily directed to a valve support device suitable for endovascular and/or transapical implantation at or near to a cardiac valve annulus, comprising one or more support rings and one or more height-increasing elements attached to the inner circumference of said support rings. Preferred embodiments of height-increasing elements for use in the present invention include wire springs of various types, fabric sleeves and tab-like elements.

A replacement heart valve system may include a delivery sheath and a replacement heart valve. The replacement heart valve may include a mesh anchor member disposed within the delivery sheath in an elongated delivery configuration, the mesh anchor member being expandable to a deployed configuration when unconstrained by the delivery sheath. The mesh anchor member may include an upstream chamber, a downstream chamber, and a tubular middle portion extending between the upstream chamber and the downstream chamber. The replacement heart valve may include a diaphragm disposed within the downstream chamber of the mesh anchor member, wherein the diaphragm is configured to selectively prevent fluid flow through the replacement heart valve.