Replacement mitral valve, delivery system for replacement mitral valve and methods of use
Devices, systems and methods are described herein a prosthesis for implantation within a lumen or body cavity and delivery systems for delivering the prosthesis to a location for implantation. A delivery system can include a plurality of components, including a flexible nose cone, multi-layer sheath, and pre-compressed shaft, which can be moveable relative to each other.
1. A transseptal delivery system, comprising:
a replacement heart valve having a first end and a second end releasably held within the delivery system in a radially compressed configuration;
a plurality of tubular restraining shafts sized for radially restraining the replacement heart valve in a radially compressed configuration, wherein the plurality of tubular restraining shafts is adapted to sequentially release the first end of the replacement heart valve followed by the second end of the replacement heart valve;
an inner shaft located within the plurality of tubular restraining shafts, the inner shaft having a retention member disposed along a distal end portion thereof, the retention member shaped to releasably engage portions of the replacement heart valve;
a spring located within a tubular distal section of one of the plurality of tubular restraining shafts, wherein a proximal end of the spring is attached to the one of the plurality of tubular restraining shafts, and wherein a distal end of the spring is attached to a cover configured to at least partially surround the retention member;
a nosecone shaft located within a lumen of the inner shaft; and
a nosecone attached to a distal end portion of the nosecone shaft,
wherein the second end of the replacement heart valve comprises struts having locking tabs, wherein the retention member is configured to releasably receive the struts, and wherein the locking tabs prevent longitudinal movement of the replacement heart valve when attached to the retention member, and
wherein the spring applies a distal force on the cover in order to prevent inadvertent release of the replacement heart valve from the retention member during bending of the transseptal delivery system.
2. The delivery system of claim 1 , wherein the tubular distal section has a larger diameter than a proximal section of the one of the plurality of tubular restraining shafts.
3. The delivery system of claim 2 , wherein in a fully extended position, the spring extends distal to the one of the plurality of tubular restraining shafts.
4. The delivery system of claim 3 , wherein a polymer layer extends further distally than the spring when the spring is in a fully compressed position.
5. The delivery system of claim 4 , wherein the proximal section is formed by a hypotube such that the proximal section has a greater column strength than the distal section.
6. The delivery system of claim 1 , wherein each of the plurality of tubular restraining shafts has a varying diameter.
7. The delivery system of claim 1 , wherein each of the plurality of tubular restraining shafts is longitudinally slidable with respect to one another.
8. The delivery system of claim 1 , wherein each of the plurality of tubular restraining shafts is configured to be individually longitudinally slidable with respect to the inner shaft and the nosecone shaft.
9. The delivery system of claim 1 , wherein the inner shaft at least partially comprises a multi-strand wire.
10. The delivery system of claim 1 , wherein the delivery system is steerable.
11. The delivery system of claim 1 , wherein the retention member includes a plurality of spaced slots sized to releasably capture the struts of the replacement heart valve.
12. The delivery system of claim 1 , wherein the nosecone is hollow.
13. The delivery system of claim 1 , further comprising a handle located on a proximal end of the delivery system, wherein the handle comprises a first actuator and a second actuator, the first actuator configured to longitudinally translate a first tubular shaft of the plurality of tubular restraining shafts and the second actuator configured to longitudinally translate a second tubular shaft of the plurality of tubular restraining shafts.
14. The delivery system of claim 1 , wherein the plurality of tubular restraining shafts consists of a first shaft and a second shaft.
15. A transseptal delivery system, comprising:
a replacement heart valve having a first end and a second end releasably held within the delivery system in a radially compressed configuration;
a first tubular restraining shaft sized for radially restraining the replacement heart valve in the radially compressed configuration;
a second tubular restraining shaft within the first tubular restraining shaft sized for radially restraining the replacement heart valve in the radially compressed configuration, wherein the first and second tubular restraining shafts are adapted to sequentially release the first end of the replacement heart valve followed by the second end of the replacement heart valve;
an inner shaft located within second tubular restraining shaft, the inner shaft having a retention member disposed along a distal end portion thereof, the retention member shaped to releasably engage portions of the replacement heart valve; and
a spring located within a tubular distal section of the second tubular restraining shaft, wherein a proximal end of the spring is attached to the second tubular restraining shaft, and wherein a distal end of the spring is attached to a cover configured to at least partially surround the retention member, wherein the spring applies a distal force on the cover in order to prevent inadvertent release of the replacement heart valve from the retention member during bending of the transseptal delivery system, and
wherein the second end of the replacement heart valve comprises struts having locking tabs, wherein the retention member is configured to releasably receive the struts, and wherein the locking tabs prevent longitudinal movement of the replacement heart valve when attached to the retention member.
16. The delivery system of claim 15 , further comprising a handle located on a proximal end of the delivery system, wherein the handle comprises a first actuator and a second actuator, the first actuator configured to longitudinally translate the first tubular restraining shaft and the second actuator configured to longitudinally translate the second tubular restraining shaft, wherein at least one of the first actuator and the second actuator is a rotational actuator.
17. The delivery system of claim 15 , wherein the inner shaft at least partially comprises a multi-strand wire.
18. The delivery system of claim 15 , wherein each of the first and second tubular restraining shafts is configured to be individually longitudinally translatable relative to the inner shaft and the other of the first and second tubular restraining shafts.
19. The delivery system of claim 15 , wherein the cover is a disc or cup-shaped cover.