An artificial chordae tendineae implantation system includes a clamping device, a puncture device, a pushing device, and a detection device. The pushing device includes a pushing shaft. The clamping device includes a clamping push rod that receives an artificial chorda tendineae, and a distal clamp and a proximal clamp for cooperatively clamping a valve leaflet. The detection device includes one probe that is movably disposed in the pushing shaft. A probe outlet is provided at one of a clamping surface of the proximal clamp and a clamping surface of the distal clamp, and a probe accommodation chamber corresponding to the probe outlet is provided at the other one. When the clamping device is closed, the distal end of the probe protrudes from the probe outlet and is accommodated in the probe accommodation chamber, and whether the valve leaflet is clamped is detected.

Dislodgment of a constricting cord from an annulus can be prevented by delivering the distal loop portion of the constricting cord to the annulus using a percutaneous delivery tool, and launching anchors into the annulus so as to affix the distal loop portion of the constricting cord to the annulus. The percutaneous delivery tool is withdrawn in a proximal direction after the anchors have been launched. A pushing member is pressed in a distal direction so that the pushing member holds a portion of the constricting cord against the annulus with enough pressure to prevent dislodgment of any of the anchors during the withdrawal of the percutaneous delivery tool.

A system for bridging a gap between an article or a portion thereof and a target, and anchoring the article or its portion to the target, the system comprising a) an elongated delivery catheter having a distal end; b) and a bridging and anchoring construction, operable to selectably translate in a distal and a proximal direction relative to the distal end of the elongated delivery catheter, the bridging and anchoring construction slidably coupled to the elongated delivery catheter, wherein the bridging and anchoring construction is operable to 1) engage the target following the distal translation spanning the gap between the article or its portion and the target; 2) eliminating the gap following the proximal translation; and 3) anchoring the article or its portion to the target.

Apparatus and methods are described herein for a secondary valve apparatus that can be deployed within an existing implanted prosthetic heart valve. In some embodiments, a secondary prosthetic heart valve apparatus is implanted in series with an existing deteriorating implanted prosthetic valve. The secondary valve apparatus can restore proper valve function without disruption to the failing previously implanted valve. In some embodiments, the secondary valve apparatus can be positioned on an atrial portion of the existing valve, and be delivered transseptally. In other embodiments, the secondary valve apparatus can be positioned at a ventricular portion of the existing valve and delivered transapically. Devices and methods to prepare the existing valve to receive a secondary valve apparatus are also described herein. In some embodiments, a balloon expansion device can be used to expand an inner diameter of the existing valve to provide space for the secondary valve to be disposed.

In one embodiment, a method of repairing a heart valve accesses an interior of a patient's beating heart minimally invasively and inserts one or more sutures into each of a plurality of heart valve leaflets with a suturing instrument. The suture ends of the sutures are divided into suture pairs, with each pair including one suture end from a suture inserted into a first valve leaflet and one suture end from a suture inserted into a second valve leaflet. One or more tourniquet tubes is advanced over the suture pairs to the leaflets to draw the sutures together to coapt the leaflets and then the sutures are secured in that position.

This application relates to methods, systems, and apparatus for replacing native heart valves with prosthetic heart valves and treating valvular insufficiency. In a representative embodiment, a support frame configured to be implanted in a heart valve comprises a main body formed by formed by a plurality of inner members forming an inner clover and a plurality of outer members forming an outer clover. The support frame can include gaps located between inner members of the plurality of inner members and outer members of the plurality of outer members. The inner clover can be radially inside the outer clover, and the outer clover can have larger dimensions than the inner clover. The support frames herein can be radially expandable and collapsible.

A method for replacing a native heart valve in need thereof comprises delivering to the native heart valve an apparatus comprising a valve member, a connecting member, and an anchor member suitable for anchoring the apparatus. The valve member reversibly moves between an open position and a closed position to augment or replace the function of the native valve leaflets, thereby reducing valve regurgitation. Some embodiments include a stent that is positioned in the native heart valve with the valve member disposed therein.

Systems for mitral valve repair are disclosed where one or more mitral valve interventional devices may be advanced intravascularly into the heart of a patient and deployed upon or along the mitral valve to stabilize the valve leaflets. The interventional device may also facilitate the placement or anchoring of a prosthetic mitral valve implant. The interventional device may generally comprise a distal set of arms pivotably and/or rotating coupled to a proximal set of arms which are also pivotably and/or rotating coupled. The distal set of arms may be advanced past the catheter opening to a subannular position (e.g., below the mitral valve) and reconfigured from a low-profile delivery configuration to a deployed securement configuration. The proximal arm members may then be deployed such that the distal and proximal arm members may grip the leaflets between the two sets of arms to stabilize the leaflets.

A system for excising an implanted clip approximating opposed valve leaflets in a heart valve includes a capture catheter configured to be introduced proximate the valve leaflets on one side of the clip, a transfer catheter configured to be introduced proximate the valve leaflets on another side of the clip, and a cutting tool configured to be deployed between the capture and transfer catheters and to be engaged against tissue of at least one of the valve leaflets and to excise the clip. A removal catheter may optionally be used to remove the clip from the heart.

Delivery system for fixation device, including guide catheter with proximal end portion having proximal end port, distal end portion having distal end port, and inner surface defining inner lumen extending in fluid communication between proximal end port and distal end port. Delivery catheter extending through the inner lumen to define annular space between outer surface of the delivery catheter and inner surface of the guide catheter. A pressure sensor proximate the proximal end portion in fluid communication with the annual space to monitor fluid pressure. The distal end portion of the guide catheter includes flow passages in fluid communication between an exterior of the distal end portion and the annular space.