Method of securing an intralumenal frame assembly

1. A method of delivering an intralumenal frame assembly to a native mitral valve, the native mitral valve having a native mitral valve annulus, the method comprising:

delivering the intralumenal frame assembly mounted on a delivery device to the native mitral valve while the intralumenal frame assembly is in a radially compacted state, wherein a tether at least partially encircles a portion of the intralumenal frame assembly during delivery, the tether configured to radially restrain a portion of the intralumenal frame assembly, the intralumenal frame assembly comprising:

a frame having a proximal end, a distal end and a middle portion and a longitudinal axis extending between the proximal and distal ends, the frame comprising a foreshortening portion comprising foreshortening cells, the foreshortening portion configured to be located within a plane of the native mitral valve annulus when the frame is expanded at the native mitral valve; and

a plurality of proximal and distal anchors configured to atraumatically engage tissue on opposite sides of the native mitral valve annulus upon deployment of the intralumenal frame assembly; and

deploying the intralumenal frame assembly so that the foreshortening portion of the frame expands within the plane of the native mitral valve annulus while the intralumenal frame assembly remains tethered with a first end and a second end of the tether extending proximally past the proximal end of the frame;

wherein after the intralumenal frame assembly has been fully deployed at the native mitral valve, a diameter of the middle portion of the frame is greater than a diameter of the proximal end of the frame, the proximal anchors are located on a first side of the plane of the native mitral valve annulus and the distal anchors are located on a second side of the plane of the native mitral valve annulus.

2. The method of claim 1 , wherein the tether fits loosely around the intralumenal frame assembly when the intralumenal frame assembly is in the radially compacted state on the delivery device.

3. The method of claim 2 , wherein, upon deploying the intralumenal frame assembly, the tether radially restrains a portion of the intralumenal frame assembly.

4. The method of claim 1 , wherein the tether is adjusted while the intralumenal frame assembly is located at the native mitral valve.

5. The method of claim 4 , wherein the tether is adjusted to reduce a circumference of the portion of the intralumenal frame assembly.

6. The method of claim 1 , further comprising engaging tissue on a left ventricular side of the native mitral valve annulus with the plurality of distal anchors.

7. The method of claim 1 , further comprising removing the tether from the intralumenal frame assembly.

8. The method of claim 1 , wherein the tether encircles an entire circumference of the intralumenal frame assembly.

9. The method of claim 1 , wherein the tether encircles the foreshortening portion.

10. The method of claim 1 , wherein the plurality of proximal anchors comprise ends which extend towards the distal end of the frame.

11. The method of claim 10 , wherein the plurality of distal anchors comprise ends which extend towards the proximal end of the frame.

12. A method of delivering an intralumenal frame assembly to a native mitral valve, the native mitral valve having a native mitral valve annulus, the method comprising:

delivering the intralumenal frame assembly mounted on a delivery device to the native mitral valve while the intralumenal frame assembly is in a radially compacted state, wherein a tether at least partially encircles a portion of the intralumenal frame assembly during delivery, the tether configured to radially restrain a portion of the intralumenal frame assembly, the intralumenal frame assembly comprising:

a frame having a proximal end, a distal end and a middle portion and a longitudinal axis extending between the proximal and distal ends, the frame comprising a foreshortening portion comprising foreshortening cells, the foreshortening portion configured to be located within a plane of the native mitral valve annulus when the frame is expanded at the native mitral valve; and

a plurality of proximal and distal anchors configured to atraumatically engage tissue on opposite sides of the native mitral valve annulus upon deployment of the intralumenal frame assembly; and

deploying the intralumenal frame assembly so that the foreshortening portion of the frame expands within the plane of the native mitral valve annulus while the intralumenal frame assembly remains tethered with a first end and a second end of the tether extending proximally past the proximal end of the frame;

wherein after the intralumenal frame assembly has been fully deployed at the native mitral valve, wherein a diameter of the middle portion is greater than a diameter of the distal end, the proximal anchors are located on a first side of the plane of the native mitral valve annulus and the distal anchors are located on a second side of the plane of the native mitral valve annulus.

13. The method of claim 12 , wherein the tether fits loosely around the intralumenal frame assembly when the intralumenal frame assembly is in the radially compacted state on the delivery device.

14. The method of claim 13 , wherein, upon deploying the intralumenal frame assembly, the tether radially restrains a portion of the intralumenal frame assembly.

15. The method of claim 12 , wherein the tether is adjusted while the intralumenal frame assembly is located at the native mitral valve.

16. The method of claim 12 , further comprising removing the tether from the intralumenal frame assembly.

17. The method of claim 12 , further comprising engaging tissue on a left ventricular side of the native mitral valve annulus with the plurality of proximal anchors.

18. A method of delivering an intralumenal frame assembly to a native valve, the native valve having a native valve annulus, the method comprising:

delivering an intralumenal frame assembly mounted on a delivery device to the native valve while the frame assembly is in a radially compacted state, wherein a tether is disposed about a portion of the intralumenal frame assembly, the tether having a first end and a second end extending proximally away from the intralumenal frame assembly, the tether being attached to the delivery device, the intralumenal frame assembly comprising:

a frame having a proximal end, a distal end and a middle portion and a longitudinal axis extending between the proximal and distal ends;

deploying the intralumenal frame assembly so that the frame expands in the native valve annulus to a first diameter; and

after deploying the intralumenal frame assembly to the first diameter, exerting a radially inward force on the frame using the tether via the delivery device, wherein exerting a radially inward force on the frame reduces a diameter of the frame to a second diameter less than the first diameter to reduce a radial load on the native valve annulus and mitigate risk of enlargement of the native valve annulus.

19. The method of claim 18 , wherein the intralumenal frame assembly further comprises a plurality of anchors configured to atraumatically engage tissue on a side of the native valve annulus upon deployment of the intralumenal frame assembly.

20. The method of claim 18 , wherein exerting the radially inward force on the frame using the tether comprises tensioning the tether around the frame.