A locking mechanism for a medical implant may include a buckle member, a post member axially translatable with respect to the buckle member, the post member including a receiving portion proximate a proximal end of the post member, a distal end, a laterally-arched central body portion extending between the receiving portion and the distal end, and a cantilevered leg extending proximally from the distal end, and an actuator element including a proximal shaft portion and a distal engagement portion, the distal engagement portion being configured to releasably engage the receiving portion of the post member. The proximal shaft portion may be pivotable with respect to the distal engagement portion.

Sealable and repositionable implant devices are provided to increase the ability of endovascular grafts and valves to be precisely deployed or re-deployed, with better in situ accommodation to the local anatomy of the targeted recipient anatomic site, and with the ability for post-deployment adjustment to accommodate anatomic changes that might compromise the efficacy of the implant. A surgical implant includes a self-expanding stent of a shape-memory material set to a given shape. The stent has a wall with a portion having a first thickness and a second portion having a thickness greater than the first. The second portion defines a key-hole shaped longitudinal drive orifice. The implant includes a selectively adjustable assembly having adjustable elements and being operable to force a configuration change in at least a portion of the self-expanding stent. The adjustable elements have a part rotatably disposed within the longitudinal drive orifice.

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 device (24) for placing a seal around an implant in a blood circulation passage is provided. The device includes a hollow sheath having a longitudinal axis, and at least one releaser, deployable relative to the sheath is provided. The device (24) includes, for the or each releaser, a sealing body (64) releasably fastened on that releaser, the sealing body (64) having an angular span smaller than 360° around the longitudinal axis, and a filiform link (67) connecting at least one releaser to another releaser and/or to the controller (68) positioned in the sheath, the filiform link (67) being deformable between a relaxed idle configuration and a stretched configuration limiting the radial movement of the sealing bodies (64).

Delivery systems for expandable and stented implants include adjustable tensioning members that control the expansion of the implant along the length of the implant. The tensioning members are wound onto one or more rotors located on the distal segment of the delivery system, which are rotated to unwind the tensioning members and incrementally expand the implant. Positioning mechanisms are also provided to adjust the position and orientation of the implant during delivery.

Disclosed embodiments and methods provide solutions for coupling and decoupling of a delivery device from a stented prosthetic heart valve with one or more release mechanisms. In situations when one or more sutures get tangled or caught upon attempted retraction of the delivery device and sutures after deployment of the stented prosthetic heart valve, a secondary release mechanism can be provided to sever the suture(s) or release the suture(s) from the delivery device. Exemplary secondary release mechanisms include high resistance inserts, cutters and balloon expandable devices. Methods of releasing the sutures from the delivery device or severing the suture(s) are also disclosed.

Exemplary embodiments provide methods and systems for delivering a prosthesis to a target location in a luminal system of a patient. At least one tether is secured proximate the target location to serve as a rail, and a prosthesis is advanced along the rail to the target location and secured in place. Exemplary methods and systems provide for repair of the mitral and tricuspid valves, as well as abdominal aortic aneurysms, stomach valves, fallopian tubes and the pulmonary system, among others. Also disclosed are various prostheses suitable for use with the disclosed methods and systems.

Stented prosthetic heart valves comprising a stent frame having a compressed arrangement for delivery within a patient's vasculature and an expanded arrangement for deployment within a native heart valve. The stented prosthetic heart valves including a paravalvular leakage prevention or mitigation wrap that encircles a stent frame and is formed of a flexible material having a variable diameter defined by a greatest distance between the wrap and the stent frame. The wrap further includes a first end coupled to the stent frame and an opposing second end that is not coupled to the stent frame, wherein the wrap can selectively enlarge its diameter in situ via movement of the second end. Devices for and methods of selectively deploying the wrap are also disclosed.

The present application relates to a transcatheter prosthetic valve replacement system including a delivery catheter, a frame, a prosthetic valve, and one or more clamping devices. The prosthetic valve is fixed in the frame. The clamping device is connected to a periphery of the frame. The frame and the clamping device can be preloaded in the delivery catheter. The clamping device includes a clamping member, a collar, and a control member. One end of the clamping member is a fixation end which is fixedly connected to the frame, and the other end of the clamping member is a deployable resilient segment which can be compressed and released. The collar is slidably sleeved on the clamping member. One end of the control member is connected to the collar, and the other end of the control member is manipulated outside the body. From being compressed to being fully released, the clamping member in sequence has two configurations. In the first configuration, the collar is moved along the clamping member towards a free end of the deployable resilient segment, and the deployable resilient segment is gradually closed. In the second configuration, the collar is moved along the deployable resilient segment towards the fixation end, and the deployable resilient segment recovers its predetermined shape.

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.