Cardiac valve delivery devices and systems
A delivery device includes a central elongate structure including an annular member at the distal end, a sheath, a plurality of tethers extending through the central elongate structure, a handle, and a control on the handle. The handle is connected to the elongate structure, the sheath, and the plurality of tether. The control is configured to move the sheath proximally and distally over the central elongate structure. The annular member includes a plurality of pockets extending radially therearound. Each tether includes a feature on a distal end thereof configured to fit within a pocket of the plurality of pockets to hold the tether in place.
1. A delivery device, comprising:
a central elongate structure comprising an annular member at a distal end thereof, the annular member including a plurality of pockets extending radially therearound;
a sheath configured to slide over the central elongate structure;
a plurality of tethers extending through the central elongate structure, each tether including a feature on a distal end thereof configured to fit within a pocket of the plurality of pockets to hold the tether in place;
a handle connected to the elongate structure, the sheath, and the plurality of tethers; and
a control on the handle configured to move the sheath proximally and distally over the central elongate structure; and
a tether controller on the handle configured to provide tension to or release tension from each of the plurality of tethers,
wherein the handle further comprises a tether lock having an open position and a closed position, the tether lock in the closed position configured to prevent further loosening or tensioning of the plurality of tethers.
2. The delivery device of claim 1 , wherein the feature is a cone or a sphere.
3. The delivery device of claim 1 , wherein the feature is radiopaque.
4. The delivery device of claim 1 , wherein the handle further comprises a locking mechanism configured to prevent the control from moving the sheath past a predetermined distance, thereby preventing the features from releasing from the pockets.
5. The delivery device of claim 4 , wherein the locking mechanism is releasable so as to allow the sheath to move past the predetermined distance to release the features from the pockets.
6. The delivery of device of claim 1 , wherein the handle further comprises a secondary release knob coupled to the tether controller for allowing the plurality of tethers to be released at their proximal ends.
7. The delivery device of claim 6 , further comprising a ratcheting assembly configured to prevent forward and back driving of the tether controller, the ratcheting assembly comprising:
a plurality of ratchets coupling the tether controller and the secondary release knob;
two beads symmetrically disposed in two channels within the secondary release knob, wherein the two beads are maintained at the bottom of the two channels with corresponding springs, and wherein tension to the two beads may be released with corresponding actuators; and
three wells adjacent to the bottom of each of the two channels such that only one well is exposed to the bottom of each of the two channels at any one time;
wherein a location of each bead in one of the three wells of each channel corresponds to limiting tether controller movement in a first direction, limiting tether controller movement in a second direction opposite the first direction, or allowing the tether controller to move in the first direction or the second direction.
8. The delivery device of claim 7 , further comprising a series of magnetic strips along one side of the device.
9. The delivery device of claim 8 , further comprising a grasper that is configured to magnetically couple to the delivery device through the series of magnetic strips, the grasper comprising:
a coupling aperture adapted to couple to a support arm; and
a grasper knob that when turned is adapted to move the delivery device in an axial direction for placing a prosthetic valve.
10. The delivery device of claim 1 , further comprising an outer sheath configured to cover a distal portion of the delivery device for maintaining an incision site during a prosthetic valve placement procedure.
11. The delivery device of claim 10 , wherein the outer sheath further comprises an annular groove at its distal end for coupling to an incision site boundary when the incision site boundary is cinched together.
12. The delivery device of claim 1 , further comprising a prosthetic valve loading aid for placing the prosthetic valve into the sheath.