Device for delivery of medical devices to a cardiac valve
A catheter device for transvascular delivery of a medical device to a cardiac valve region of a patient comprises an elongate sheath with a first lumen, a distal end for positioning at a heart valve, a second lumen that extends parallel to or in the sheath, and an expandable embolic protection filter. The filter is arranged to extend from an orifice of the second lumen and, in the expanded state, covers ostia of the side branch vessels in the aortic arch.
1. A transvascular catheter device comprising:
an elongate sheath with a first lumen and a distal end, said distal end being configured for positioning at a heart valve,
a second lumen that extends coaxially with said first lumen along a portion of said elongate sheath between a proximal end of said elongate sheath and said distal end,
an expandable embolic protection filter having an unexpanded delivery shape and a non-tubular expanded shape, and
a plurality of radially expandable units arranged for temporarily positioning said elongate sheath at a desired position in relation to said cardiac valve when said expandable units are in an expanded state
wherein:
at least a portion of said expandable embolic protection filter is arranged to extend from an orifice of said second lumen;
said orifice is positioned proximally with respect to said distal end of said elongate sheath;
the embolic protection filter is constructed so that, when extended from said orifice, the embolic protection filter expands from the unexpanded delivery shape to a substantially planar shape that covers ostia of side branch vessels in an aortic arch and stabilizes said distal end of said sheath; and
said elongate sheath comprises releasable locking members configured to controllably lock at least a portion of said elongate sheath in a locked shape.
2. The transvascular catheter device according to claim 1 , wherein said embolic protection filter comprises a connection point arranged off-centre on said embolic protection filter and configured for connection to a delivery means.
3. The transvascular catheter device according to claim 1 , wherein said second lumen is affixed to or integral with said elongate sheath and wherein said embolic protection filter is configured such that, when in an expanded state, said filter anchors a portion of said sheath in the aortic arch.
4. The transvascular catheter device according to claim 1 , further comprising an elongate member that is retractably insertable into said first lumen and wherein a distal end portion of said elongate member comprises-said plurality of radially expandable units.
5. The transvascular catheter device of claim 4 , wherein said elongate member comprises a proximal marker and is configured to be retractably inserted into said first lumen to a length equal to a distance between the distal end of said sheath and said proximal marker.
6. The transvascular catheter device of claim 1 , wherein said elongate sheath is configured to be transvascularly delivered in a relaxed state and to transition from said relaxed state to said locked state by said releasable locking members.
7. The transvascular catheter device of claim 1 , wherein said second lumen is affixed to or integral with an outer portion of said elongate sheath; or wherein said second lumen is affixed to or integral with an inside portion of said elongate sheath.
8. The transvascular catheter device of claim 1 , wherein said plurality of radially expandable units comprises expandable balloons.
9. The transvascular catheter device of claim 8 , wherein said plurality of radially expandable units comprises three expandable balloons positioned radially equidistant around a longitudinal axis of said elongate sheath.
10. The transvascular catheter device of claim 1 , wherein said plurality of radially expandable units comprises expandable mechanical levers retractable into said sheath.
11. The transvascular catheter device of claim 1 , wherein said elongate sheath comprises radiopaque fiducial markers.
12. The transvascular catheter device of claim 1 , wherein said locking members comprise one or more of a draw string, a releasable latch, and a squeezing mechanism.
13. A kit comprising the transvascular catheter device of claim 1 and a medical device for a cardiac valve.
14. The kit of claim 13 , wherein said medical device is an artificial replacement valve or an annuloplasty implant.
15. The kit of claim 13 , wherein said cardiac valve is an aortic valve of said patient or a mitral valve.
16. The transvascular catheter device of claim 1 , wherein said plurality of radially expandable units comprises sponges that are retractable into said sheath.
17. The transvascular catheter device of claim 1 , wherein said device is configured for transaxial delivery.
18. The transvascular catheter device of claim 1 , wherein said device is configured for transfemoral delivery.
19. A transvascular catheter device comprising:
an elongate sheath with a first lumen and a distal end, said distal end being configured for positioning at a heart valve,
a second lumen that extends coaxially with said first lumen along a portion of said elongate sheath between a proximal end of said elongate sheath and said distal end,
an expandable embolic protection filter having a delivery shape and a non-tubular expanded shape, and
one or more radially expandable units arranged for temporarily positioning said elongate sheath at a desired position in relation to said cardiac valve when said expandable units are in an expanded state
wherein:
at least a portion of said expandable embolic protection filter is arranged to extend from an orifice of said second lumen;
said orifice is positioned proximally with respect to said distal end of said elongate sheath;
the embolic protection filter is constructed so that, when extended from said orifice, the embolic protection filter expands from a delivery shape to a non-tubular shape that covers ostia of side branch vessels in an aortic arch and stabilizes said distal end of said sheath.