A replacement heart valve implant may include an expandable framework configured to shift from a collapsed configuration to an expanded configuration, the expandable framework having an inflow end and an outflow end, a plurality of valve leaflets secured to the expandable framework, and a plurality of pockets secured to the expandable framework in a plurality of circumferential pocket rows. The plurality of pockets extends radially outward from the expandable framework to capture retrograde fluid flow around an exterior of the expandable framework within the plurality of pockets.

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 to rotationally align a prosthetic valve mounted on the delivery apparatus with native anatomy, 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 distal shoulder mounted on the distal end portion of the second shaft and arranged within a distal end portion of the balloon. The distal shoulder comprises a base portion and a flared portion that extends radially outward from the base portion, and a radiopaque marker is disposed on the flared portion.

A corneal implant and methods of forming and implanting the implant are described. The corneal implant comprises a portion of corneal endothelial tissue and a portion of scleral tissue. The corneal implant is keyhole shaped, with a disc portion and a tail portion. The tail portion may further comprise a perforated section.

Methods and systems for attaching a radiopaque marker to a prosthetic heart valve to indicate a location of a commissure of the prosthetic heart valve are disclosed. As one example, a prosthetic heart valve can include a frame, a plurality of leaflets arranged within the frame, and at least one commissure comprising an attachment member comprising a central portion and a flap extending outward from the central portion, the flap folded over a radially outward facing side of the central portion, and the attachment member arranged across a selected cell of the frame. The commissure further comprises commissure tabs of two adjacent leaflets coupled to a radially inward facing side of the central portion, and a radiopaque marker arranged on the flap of the attachment member, between the flap and the radially outward facing side of the central portion.

Methods and systems for attaching a radiopaque marker to a prosthetic heart valve to indicate a location of a commissure of the prosthetic heart valve are disclosed. As one embodiment, a prosthetic heart valve can include a frame including a plurality of struts forming a plurality of cells of the frame arranged between an inflow end and an outflow end of the frame, a plurality of leaflets arranged within the frame, at least one commissure comprising an attachment member arranged across a selected cell of the plurality of cells of the frame and attached to struts of the frame forming the selected cell, and commissure tabs of two adjacent leaflets coupled to the attachment member, and a radiopaque marker arranged on the attachment member of the commissure. The marker is configured to indicate a location of the commissure of the prosthetic heart valve.

Methods and systems for attaching a radiopaque marker to a prosthetic heart valve to indicate a location of a commissure of the prosthetic heart valve are disclosed. As one embodiment, a prosthetic heart valve can include a frame including a plurality of struts forming a plurality of cells of the frame arranged between an inflow end and an outflow end of the frame, a plurality of leaflets arranged within the frame, at least one commissure comprising an attachment member arranged across a selected cell of the plurality of cells of the frame and attached to struts of the frame forming the selected cell, and commissure tabs of two adjacent leaflets coupled to the attachment member, and a radiopaque marker arranged on the attachment member of the commissure. The marker is configured to indicate a location of the commissure of the prosthetic heart valve.

An implantable device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. In some implementations, the implantable device or implant, or one or more portions thereof, can be configured to expand and/or contract. For example, the implantable device or implant can narrow during delivery and expand on implantation on the native 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 method can comprise advancing a distal end portion of a delivery apparatus toward a native valve; visualizing under fluoroscopy and for a selected imaging view, a position of a radiopaque marker on the distal end portion relative to a guidewire extending through the delivery apparatus, the marker circumferentially offset from a selected commissure of the radially compressed prosthetic valve by a predetermined amount that is determined based on the selected imaging view; rotating the delivery apparatus until the marker is centered along the guidewire; and advancing the distal end portion into the native valve and inflating the balloon to radially expand and implant the prosthetic valve in the native valve such that the selected commissure is aligned with a commissure of the native valve.

Balloon covers for a delivery apparatus for a prosthetic valve are disclosed. As one embodiment, a balloon cover includes first and second shell members that are configured to matingly engage with each other, each of the first and second shell members including a first portion and a second portion, the second portion having a larger width than the first portion. The first portions of the first and second shell members define a first cavity configured to receive a distal end portion of the delivery apparatus and at least a portion of an inflatable balloon mounted on the distal end portion of the delivery apparatus. The second portions of the first and second shell members define a second cavity configured to receive a positioning device mounted on the distal end portion of the delivery apparatus, proximal to a valve mounting portion of the distal end portion of the delivery apparatus.

Balloon covers for a delivery apparatus for a prosthetic valve are disclosed. As one embodiment, a balloon cover includes first and second shell members that are configured to matingly engage with each other, each including a first portion defining a first cavity configured to receive a distal end portion of the delivery apparatus and at least a portion of an inflatable balloon. The balloon cover includes one or more depression members, each having a free end configured to move radially inward toward a central longitudinal axis of the balloon cover, and a tubular sleeve configured to be positioned around the depression members and the first portions of the first and second shell members such that the first and second shell members are held in mating engagement with each other and the free ends of the depression members are depressed radially inward and form a negative radial depression in the balloon.