Repositioning wires and methods for repositioning prosthetic heart valve devices within a heart chamber and related systems, devices and methods
The invention provides methods, devices and systems for delivering, positioning and/or repositioning an expandable prosthetic heart valve in a patient's heart chamber. At least one non-looped wire and looped wire pair is operatively connected with an expanded prosthetic heart valve that is collapsed within a delivery catheter lumen having its distal end positioned in the subject heart chamber. The collapsed prosthetic heart valve is translated through the delivery catheter lumen to and out of its distal end where the prosthetic heart valve expands to a working configuration. The wire(s) of the non-looped and looped wire pair may be manipulated by pulling proximately or pushing distally to position or reposition the expanded prosthetic stent into position, then released from connection with the positioned stent and withdrawn from the patient.
1. A method for delivering, positioning and/or repositioning a collapsible and expandable stent having a stent frame within a patient's heart chamber, comprising:
providing at least three non-looped wire and looped wire pairs, wherein a distal end of each of the at least three wire pairs is operatively and releasably connected with a corresponding junction between two struts of the stent such that, for each of the at least three non-looped wire and looped wire pairs, the non-looped wire wraps around the junction and extends through a loop formed on the distal end of the looped wire, and wherein proximal ends of each wire in the at least three wire pairs extend outside the patient;
providing a delivery catheter comprising a lumen with a proximal end and a distal end;
positioning the distal end of the delivery catheter within the heart chamber;
advancing the stent in an expanded configuration into the proximal end of the lumen of the delivery catheter and collapsing the stent to a collapsed configuration;
translating the collapsed stent in the collapsed configuration distally through the lumen of the delivery catheter;
delivering the collapsed stent out of the distal end of the lumen of the delivery catheter and expanding the stent to an expanded working configuration;
manipulating the proximal ends of each wire in the at least three non-looped wire and looped wire pairs to position the expanded stent within the patient's heart chamber;
releasing the non-looped wire from the looped wire to disconnect each of the at least three non-looped wire and looped wire pairs from the expanded and positioned stent; and
withdrawing each non-looped wire and looped wire proximally through the delivery catheter lumen.
2. The method of claim 1 , wherein the patient's heart chamber comprises the left atrium and the delivery catheter is positioned to provide a transseptal delivery of the expanded stent into the left atrium.
3. The method of claim 2 , wherein the stent comprises a lower end and an upper end, wherein the lower end is positioned adjacent to the patient's native mitral valve.
4. The method of claim 1 , wherein the delivery catheter is positioned to provide access to the patient's heart chamber by one of the group of delivery techniques consisting of: transapical; transfemoral; transatrial; and transseptal.
5. The method of claim 4 , wherein the junction between the two struts is located at a lower end of the stent.
6. The method of claim 4 , wherein the stent comprises a lower outer surface at least partially covered by a fabric skirt, wherein the at least three non-looped wire and looped wire pairs extend through the fabric skirt, and wherein the junction between the two struts is located at the lower end of the stent.
7. The method of claim 1 , wherein each wire pair of the at least three wire pairs engaging a junction between two struts at a location that is spaced apart from the other wire pairs.
8. The method of claim 7 , further comprising providing a releasable lock operatively engaging each looped wire of the at least three non-looped and looped wire pairs.
9. The method of claim 1 , further comprising providing a releasable lock operatively engaging the proximal end of the non-looped wire in each of the at least three non-looped and looped wire pairs.
10. The method of claim 9 , wherein locking the releasable lock corresponding to one of the at least three non-looped and looped wire pairs prevents the non-looped and looped wires of that wire pair from moving relative to each other.
11. The method of claim 9 , wherein unlocking the releasable lock from the non-looped wire of one of the at least three non-looped and looped wire pairs allows relative movement between the non-looped wire and the looped wire of that non-looped and looped wire pair.