A modular heart valve prosthesis includes a first heart valve device and a second heart valve device. The first heart valve device includes a first valve support including a first prosthetic valve disposed within the valve support, and an anchoring frame surrounding the first valve support and coupled to the first valve support. The first prosthetic valve includes synthetic fabric leaflets having a first thickness. The second heart valve device includes a second valve support including a second prosthetic valve disposed within the second valve support. The second prosthetic valve includes tissue leaflets having a second thickness, wherein the second thickness is greater than the first thickness. In a first configuration, the second heart valve device is separate from the first heart valve device, and in a second configuration, the second heart valve device is disposed within the first valve support of the first heart valve device.

An anchoring device that can be positioned within a native valve, such as the native mitral valve, to secure a replacement prosthetic valve in place. The anchoring device can comprise a docking station formed of a super elastic wire-like member defining a continuous, closed shape. The docking station can have an upper or atrial ring with at least two ring portions or half rings that are spaced apart across gaps. Descending bends from the ends of the two ring portions lead to a pair of anchors. The anchors can include oppositely-directed rounded V-shaped arms that extend generally parallel to the upper ring. When installed by a delivery device, the anchors can be located in the subvalvular space or the region/vicinity of the native leaflets and pinch the leaflets and the annulus against the upper ring which is located on the other side of the annulus.

A modular valve prosthesis includes an anchor stent and a valve component. The anchor stent includes a self-expanding tubular frame member configured to be deployed in the aorta and a proximal arm component extending from a proximal end of the tubular frame member and configured to be deployed in the sinuses of the aortic valve. The anchor stent further includes attachment members extending from an internal surface of the tubular frame member. The valve component includes a valve frame configured to be deployed within the tubular frame member of the anchor stent such that the valve frame engages with the attachment members of the tubular frame member and a prosthetic valve coupled to the valve frame.

A method of placing a valve in a tubular organ including the steps of delivering an expandable tubular adapter to a site within the tubular organ, wherein the adapter includes an enclosed volume surrounded by an outer wall that is spaced from an inner wall, and first and second end walls. The method further includes expanding the outer wall relative to the inner wall so that the outer wall contacts the tubular organ, and placing a valve within the inner wall of the adapter. The method may further include inserting material into the enclosed volume of the adapter to expand the outer wall relative to the inner wall, which material may include liquid or gel. Alternatively, the valve may be positioned within the inner wall prior to the adapter being delivered to the desired site.

Apparatus and methods are described including placing a valve frame within a subject's heart. The valve frame includes a valve frame body that is configured to support the prosthetic valve within the native atrio-ventricular valve, and at least one arm that is configured to extend from a ventricular portion of the valve frame. The at least one arm is deployed among chords of the native atrio-ventricular valve. Subsequently, at least a portion of the valve frame is rotated in a direction in which an interior of the arm faces, such as to modify shapes of the native valve leaflets and the ventricular structures, by recruiting and deflecting at least a portion of the chords. The frame body of the valve frame is then radially expanded, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes. Other applications are also described.

A prosthetic heart valve can include an outer support assembly, an inner valve assembly, which define between them an annular space, and a pocket closure that bounds the annular space to form a pocket in which thrombus can be formed and retained. Alternatively, or additionally, the outer support assembly and the inner valve assembly can be coupled at the ventricle ends of the outer support assembly and the inner valve assembly, with the outer support assembly being relatively more compliant in hoop compression in a central, annulus portion than at the ventricle end, so that the prosthetic valve can seat securely in the annulus while imposing minimal loads on the inner valve assembly that could degrade the performance of the valve leaflets.

A system includes a core and a catheter for use with (A) a first atrial arm and a first ventricular arm articulatable with respect to each other at a first articulation site to clamp one leaflet of a patient's native heart valve, and (B) a second atrial arm and a second ventricular arm articulatable with respect to each other at a second articulation site to clamp another native leaflet of the native valve. The core tapers in a distal direction toward its smallest perimeter, defining a minimum nonzero angle of the atrial arms with respect to a central longitudinal axis of the core. The catheter advances the core and the arms toward the native valve. The catheter and the core have an advancement configuration in which the smallest perimeter of the core is adjacent to the first and second articulation sites. Other embodiments are also described.

An implant includes a clip and a clip-controller interface. The clip is disposed laterally from a central longitudinal axis of the implant, includes first and second arms articulatably coupled to each other, and sandwiches a leaflet of a heart valve between the first and second arms by articulation between the first and second arms, such that the second arm is disposed laterally from the first arm. The clip-controller interface is reversibly coupled to a clip controller of a delivery tool, and includes first and second portions. The first portion is linearly slidable by the clip controller. The second portion is articulatably coupled to the first portion and to the second arm, such that linear sliding of the first portion causes the second portion to (i) articulate with respect to the first portion, and (ii) push the second arm to articulate toward the axis. Other embodiments are also described.

A prosthetic mitral valve with improved blood flow to the left ventricular outflow tract (LVOT). The prosthetic mitral valve includes an expandable outer stent having an atrial end and a ventricular end, and an expandable inner stent attached to and at least partially positioned within the outer stent. The inner stent has an inflow end, an outflow end and a connector securing a tether. A valve assembly including a cuff and a plurality of leaflets may be disposed within the inner stent. The outer stent is expandable from a delivery condition in which the outer stent is axially elongated to a deployed condition in which a first portion of the outer stent is folded upon a second portion of the outer stent to define a flange for engaging an atrial surface of a native valve annulus and to stabilize the prosthetic heart valve within the native valve annulus.

Endovascular systems for deployment at branched arteries include a main tubular graft body deployable within a main artery including a proximal end and an opposed distal end. The proximal and distal ends have a tubular graft wall therein between. A plurality of inflatable channels are disposed along the main tubular graft body, and at least one stent segment is disposed along the tubular graft wall of the main tubular graft body. The plurality of inflatable channels are configured to be inflatable with an inflation medium. The at least one stent segment is disposed between two or more adjacent inflatable channels of the plurality of inflatable channels.