Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath

1. A catheter system comprising:

a delivery catheter configured to deliver a prosthetic heart valve, the delivery catheter having a proximal end and a distal end, and comprising a tip at the distal end that includes a first sleeve and a second sleeve movable relative to each other in a proximal-distal direction, wherein the second sleeve is proximal to the first sleeve, and the first sleeve has an open end facing in a proximal direction, and wherein a middle section of the tip is uncovered when the first sleeve is in a proximal-most position while the second sleeve is in a distal-most position, the delivery catheter having a holder disposed in the second sleeve;

an introducer comprising a sheath;

a steering catheter configured to be deflected to steer the delivery catheter; and

an integrated handle comprising a delivery handle portion and a steering handle portion comprising a housing, the housing of the steering handle portion sized and configured to receive the delivery handle portion, the integrated handle configured to control movement of the delivery catheter and the steering catheter, independently;

an actuator movably coupled to the delivery handle portion and configured to move with respect to the delivery handle portion to manipulate the first sleeve and the second sleeve relative to the holder while the delivery handle portion is received by the housing of the steering handle portion,

wherein the steering catheter is fixedly connected to the steering handle portion and the delivery catheter is fixedly connected to the delivery handle portion, and

wherein the steering catheter and the delivery catheter are selectively coaxially and rotationally independently movable.

2. The catheter system according to claim 1 , wherein the steering catheter comprises a control wire to deflect the steering catheter to steer the delivery catheter.

3. The catheter system according to claim 1 , wherein the sheath is extendable through a vascular duct and comprises a crimping section.

4. The catheter system according to claim 1 , further comprising the prosthetic heart valve, wherein the first sleeve secures a distal end of the prosthetic heart valve to the delivery catheter and the second sleeve secures a proximal end of the prosthetic heart valve to the delivery catheter, and wherein at least a portion of the prosthetic heart valve is disposed in the middle section of the tip and not covered by the first sleeve or the second sleeve prior to movement of either the first sleeve or the second sleeve during deployment of the prosthetic heart valve.

5. The catheter system according to claim 4 , wherein a diameter of the prosthetic heart valve varies over a length of the prosthetic heart valve when the prosthetic heart valve is secured to the delivery catheter.

6. The catheter system according to claim 4 , wherein the delivery catheter comprises a holding tube, and the prosthetic heart valve is secured to the delivery catheter by the holding tube.

7. The catheter system according to claim 6 , wherein the distal end or the proximal end of the prosthetic heart valve comprises a male connector, and the delivery catheter comprises a female connector complimentary to the male connector of the prosthetic heart valve.

8. The catheter system according to claim 1 , wherein an inner diameter of the sheath is less than 24 French.

9. The catheter system according to claim 1 , wherein the sheath has a pre-shaped, curved configuration.

10. The catheter system according to claim 1 , wherein the sheath comprises a flexible polymer, a hydrophilic coating, a PTFE liner, coil reinforcement, braid reinforcement, or a combination thereof.

11. The catheter system according to claim 1 , wherein the delivery handle portion comprises a first handle configured to control movement of the delivery catheter and the steering handle portion comprises a second handle configured to control movement of the steering catheter.

12. The catheter system according to claim 11 , wherein the second handle of the steering catheter comprises a second actuator to deflect a shaft of the delivery catheter from a relaxed configuration into a curved configuration.

13. The catheter system according to claim 1 , wherein the steering catheter, the delivery catheter, and the sheath are circumferentially independently movable when the steering catheter and the delivery catheter are simultaneously disposed in the sheath.

14. The catheter system according to claim 1 , wherein the delivery catheter and the steering catheter are simultaneously introducible into the sheath.

15. A catheter system comprising:

a delivery catheter configured to deliver a prosthetic heart valve, the delivery catheter having a proximal end and a distal end, and comprising a tip at the distal end that includes a first sleeve and a second sleeve movable relative to each other in a proximal-distal direction, wherein the second sleeve is proximal to the first sleeve, and the first sleeve has an open end facing in a proximal direction, the delivery catheter having a holder disposed in the second sleeve;

a steering catheter configured to be deflected to steer the delivery catheter;

an introducer comprising a crimping section proximal to a sheath, the crimping section having an inner diameter that decreases in a distal direction; and

an integrated handle comprising a delivery handle portion fixedly connected to the delivery catheter and a steering handle portion comprising a housing fixedly connected to the steering catheter, the housing of the steering handle portion sized and configured to receive the delivery handle portion, the integrated handle configured to control movement of the delivery catheter and the steering catheter, independently;

an actuator movably coupled to the delivery handle portion and configured to move with respect to the delivery handle portion to manipulate the first sleeve and the second sleeve relative to the holder while the delivery handle portion is received by the housing of the steering handle portion,

wherein the delivery catheter and the steering catheter are simultaneously introducible into the crimping section of the introducer; and

wherein the steering catheter, the delivery catheter, and the sheath are rotationally independently movable when the steering catheter and the delivery catheter are simultaneously disposed in the sheath.

16. The catheter system according to claim 15 , wherein a middle section of the tip is uncovered when the first sleeve is in a proximal-most position while the second sleeve is in a distal-most position.

17. The catheter system according to claim 16 , further comprising the prosthetic heart valve, wherein the first sleeve secures a distal end of the prosthetic heart valve to the delivery catheter and the second sleeve secures a proximal end of the prosthetic heart valve to the delivery catheter, and wherein at least a portion of the prosthetic heart valve is disposed in the middle section of the tip.

18. The catheter system according to claim 17 , wherein at least one of the distal end or the proximal end of the prosthetic heart valve comprises a first connector, and the delivery catheter comprises a second connector complimentary to the first connector.

19. The catheter system according to claim 18 , wherein the first connector comprises eyelets, and the second connector comprises recesses.

20. The catheter system according to claim 17 , wherein a central segment of the prosthetic heart valve is compressed from a first diameter to a second diameter smaller than the first diameter when the delivery catheter passes through the crimping section.

21. The catheter system according to claim 15 , wherein a proximal end of the sheath comprises a hemostasis valve.