A delivery apparatus for controlling implantation of a prosthetic heart valve includes a handle housing and a release mechanism mounted on the handle housing. The release mechanism can be operably coupled to at least one actuation shaft. Actuation of the release mechanism can cause a distal end portion of the actuation shaft to be connected to or released from the prosthetic heart valve. The handle also includes an indicator tab configured to indicate whether the actuation shaft if connected to or released from the prosthetic heart valve.

A delivery device for percutaneously delivering a stented prosthetic heart includes a sheath, a handle, and adjustment device including a fine adjustment mechanism, and an outer stability shaft. The sheath defines a lumen and is configured to compressively constrain the stented prosthetic heart valve. The handle is coupled to the proximal portion of the sheath and includes an actuator mechanism coupled to a proximal portion of the sheath that is configured to selectively move the sheath relative to the housing to release the stented prosthetic heat valve. The adjustment device is coupled to the handle and includes an adjustment lumen through which the sheath and the handle slidably extend. The outer stability shaft is coupled to the adjustment device. The fine adjustment mechanism is configured to selectively move the handle and the sheath relative to the adjustment device and the outer stability shaft.

A constricting cord can be delivered to the vicinity of an annulus using an apparatus that includes a set of support arms, with a respective anchor launcher supported by each of the support arms. An inflatable first balloon is configured to push the support arms away from each other when the first balloon is inflated. An inflatable second balloon is mounted to a shaft and is configured for inflation when the second balloon is disposed distally beyond the first balloon. In some embodiments, the distal balloon is inflated while it is in a ventricle. In some embodiments, the distal balloon is inflated while it is in a pulmonary artery.

A medical device delivery system includes a joining element with a bumper having a distal end portion configured to engage a proximal portion of a medical device and a proximal end portion adjacent a distal end portion of an elongated tubular member. The proximal end portion defines a slot having a length along a first direction. The joining element further includes an aperture extending through the bumper and having a first, greater, cross-sectional dimension along a second direction and a second, smaller, cross-sectional dimension along a third direction. The system can include an elongated shaft having a distal region and a flattened region proximal of the distal region, the flattened region having a greatest cross-sectional dimension that is smaller than the first cross-sectional dimension but larger than the second cross-sectional dimension The flattened region can be received within the slot.

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 stent system is provided comprising a primary stent for location in a lumen of a target vessel, such as a vein or artery that may be fully or partially occluded. The primary stent contacts a vessel wall and at least one secondary stent element is deployed wholly within the primary stent and configured to engage with the interior surface of the primary stent. The secondary stent element is configured to apply a chronic outward radial force to the interior surface of the primary stent so as to effect modification of or to resist change to an aspect ratio of the lumen of the target vessel at the location where the secondary stent element is deployed. In this way the secondary stent element cooperates with the primary stent to restore patency to the target vessel. Various configurations of the stent system are provided as well as deployment devices and methods of treating fully or partially occluded vessels.

Embodiments of the present disclosure provide a delivery apparatus for a prosthetic heart valve. Disclosed delivery apparatuses can include a handle, a first shaft extending from the handle, a second shaft disposed around the first shaft, and a valve cover. The valve cover can be coupled to a distal end portion of the first shaft and can be configured to house a prosthetic heart valve in a radially compressed state. The valve cover can have an outer diameter greater than an outer diameter of the second shaft, and the first shaft and valve cover can be movable together in an axial direction relative to the second shaft.

Stent delivery device including an inner member having a distal tip, a stent support member, and a stent disposed over a stent receiving region of the stent support member. An elongated outer sheath is slidably disposed over the inner member and the stent. The stent delivery device includes a distal junction removably coupling the distal end of the outer sheath to the distal tip, where the distal junction is actuatable to decouple the outer sheath from the distal tip. The stent delivery device includes a proximal junction removably coupling a distal portion of the outer sheath to a proximal portion of the outer sheath, where the proximal junction is actuatable to decouple the distal portion of the outer sheath from the proximal portion of the outer sheath. The distal and proximal junctions may be separately actuatable by rotating the inner member relative to the proximal portion of the outer sheath.

A delivery apparatus for implanting a radially compressible and expandable prosthetic heart valve in a native heart valve of the heart includes a handle portion and an elongated shaft extending from and movable relative to the handle portion. The shaft includes a proximal end portion coupled to the handle portion and a distal end portion configured to mount a prosthetic heart valve in a radially compressed state. The handle portion includes a control member movable longitudinally with respect to the handle portion, the control member engaging a gear assembly operable to convert longitudinal motion of the control member to rotational motion of the gear assembly. The gear assembly engages the elongated shaft such that rotational motion of the gear assembly causes corresponding longitudinal motion of the elongated shaft relative to the handle portion.

A prosthetic heart valve includes a frame, a valve, and an expansion element. The frame is movable between contracted and expanded configurations and includes first struts and second struts non-hingedly coupled together. The second struts are configured to pivot relative to the first struts as the frame moves between the contracted and expanded configurations. The valve is coupled to the frame and includes leaflets. The expansion element extends through a lumen of the first struts. The expansion element is slidable relative to the lumen of the first struts and is configured to move the frame incrementally from the contracted configuration and the expanded configuration and from the expanded configuration to the contracted configuration.