Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
The present disclosure relates to a delivery catheter and the stepwise release of a stent from the catheter into the vasculature of a patient, as well as a loading device for a transcatheter heart valve (THV) prosthesis.
1. A catheter system for deployment of a heart valve prosthesis, the catheter system comprising:
a first retaining sleeve configured to house a first portion of the heart valve prosthesis in a first compressed state;
a second retaining sleeve disposed distal to the first retaining sleeve and configured to house a second portion of the heart valve prosthesis in a second compressed state;
a catheter shaft extending between and coupled to the first retaining sleeve and the second retaining sleeve; and
a stent holder configured to be disposed within the first retaining sleeve to releasably engage the heart valve prosthesis in a first position and to move relative to the first retaining sleeve to a second position to deploy the heart valve prosthesis,
wherein the second retaining sleeve is axially movable with respect to the catheter shaft, the first retaining sleeve is axially fixated to the catheter shaft, the stent holder is axially movable with respect to the catheter shaft, and the first retaining sleeve and the second retaining sleeve are configured to house the heart valve prosthesis such that an exposed portion of the heart valve prosthesis extends between the first retaining sleeve and the second retaining sleeve.
2. The catheter system of claim 1 , wherein the catheter system is configured to deploy the heart valve prosthesis by sequentially releasing the second portion of the heart valve prosthesis from the second retaining sleeve followed by moving the stent holder with respect to the first retaining sleeve resulting in liberation of the first portion of the heart valve prosthesis and deployment of the heart valve prosthesis.
3. The catheter system of claim 1 , wherein the first retaining sleeve and the second retaining sleeve are sized and configured such that a first diameter of the first retaining sleeve and a second diameter of the second retaining sleeve is less than an exposed diameter of an exposed portion of the heart valve prosthesis.
4. The catheter system of claim 1 , wherein the stent holder is configured to be disposed within the first retaining sleeve.
5. The catheter system of claim 1 , wherein the stent holder is configured to releasably engage eyelets of the heart valve prosthesis.
6. The catheter system of claim 1 , wherein the heart valve prosthesis comprises a first end and a second end and the second retaining sleeve is configured to deploy the second end and the stent holder is configured to deploy the first end.
7. The catheter system of claim 6 , wherein the stent holder is configured to release the first end of the heart valve prosthesis after the second end is released by the second retaining sleeve.
8. The catheter system of claim 1 , further comprising a plunger disposed at a proximal end of the catheter system, the plunger configured to move toward a distal end of the catheter system to move the second retaining sleeve.
9. The catheter system of claim 8 , wherein the catheter shaft comprises an outer shaft and an internal shaft disposed within the outer shaft, the internal shaft coupled to the second retaining sleeve and in mechanical communication with the plunger.
10. The catheter system of claim 1 , further comprising a lock configured to avoid premature deployment of the heart valve prosthesis.
11. The catheter system of claim 1 , wherein the exposed portion of the heart valve prosthesis expands radially outward while extended between the first retaining sleeve and the second retaining sleeve.
12. The catheter system of claim 1 , wherein the second retaining sleeve is disposed on the catheter shaft distal to the first retaining sleeve.
13. A method for deploying a heart valve prosthesis using a catheter system comprising a first retaining sleeve, a second retaining sleeve disposed distal to the first retaining sleeve, a catheter shaft extending between and coupled to the first retaining sleeve and the second retaining sleeve, and a stent holder configured to be disposed within the first retaining sleeve, the method comprising:
retaining a heart valve prosthesis in a compressed state such that the first retaining sleeve houses a first portion of the heart valve prosthesis, the second retaining sleeve houses a second portion of the heart valve prosthesis independently deployable from the first portion, and the stent holder releasably engages the heart valve prosthesis;
releasing the second portion of the heart valve prosthesis by axially moving with respect to the catheter shaft the second retaining sleeve in a first direction;
moving the stent holder axially with respect to the catheter shaft in a second direction that is the same as the first direction; and
causing the stent holder to release the heart valve prosthesis to deploy the heart valve prosthesis.
14. The method of claim 13 , wherein retaining the heart valve prosthesis comprises housing the heart valve prosthesis within the first retaining sleeve and the second retaining sleeve such that an exposed portion of the heart valve prosthesis extends between the first retaining sleeve and the second retaining sleeve.
15. The method of claim 14 , wherein an exposed diameter of the exposed portion of the heart valve prosthesis is larger than a first diameter of the first retaining sleeve and a second diameter of the second retaining sleeve.
16. The method of claim 13 , further comprising sterilizing the first retaining sleeve, the second retaining sleeve, and the stent holder together with the heart valve prosthesis.
17. The method of claim 13 , wherein the heart valve prosthesis comprises a first end and a second end and moving the second retaining sleeve in a first direction releases the first end of the heart valve prosthesis.
18. The method of claim 17 , wherein causing the stent holder to release eyelets of the heart valve prosthesis releases the second end of the heart valve prosthesis.
19. The method of claim 13 , wherein maneuvering the second retaining sleeve comprises moving a plunger disposed at a proximal end of the catheter system toward a distal end of the catheter system, the second retaining sleeve disposed at the distal end of the catheter system.
20. The method of claim 19 , wherein moving the plunger moves a catheter shaft coupled to the second retaining sleeve and in mechanical communication with the plunger.
21. The method of claim 13 , wherein maneuvering the stent holder comprises moving a plunger disposed at a proximal end of the catheter system toward a distal end of the catheter system, the stent holder disposed at the distal end of the catheter system.
22. The method of claim 13 , further comprising, disengaging a lock of the catheter system configured to avoid premature deployment of the heart valve prosthesis.
23. The method of claim 13 , wherein the stent holder releasably engages eyelets of the heart valve prosthesis and causing the stent holder to release the heart valve prosthesis comprises causing the stent holder to release the eyelets of the heart valve prosthesis to deploy the heart valve prosthesis.
24. The method of claim 13 , wherein a portion of the heart valve prosthesis between the first retaining sleeve retaining the first portion of the heart valve prosthesis and the second retaining sleeve retaining the second portion of the heart valve prosthesis expands radially outward.
25. The method of claim 13 , wherein the second retaining sleeve is disposed on a catheter shaft distal to the first retaining sleeve.