Heart valve therapeutic device

1. A heart valve therapeutic device for placement across a patient's native heart valve, the heart valve therapeutic device comprising:

a support; and

a coaptation assist valve comprising a conduit comprising a side wall, the conduit coupled to the support such that the conduit is configured to reside across the native heart valve, and a prosthetic valve mounted within the conduit, wherein the conduit has a radial dimension and an axial dimension between a proximal end and a distal end of the conduit, the conduit configured to allow blood flow through a channel within the conduit via the prosthetic valve, the side wall having an external surface configured to coapt with native leaflets of the native heart valve, wherein the side wall is unsupported between the distal end and the proximal end.

2. The heart valve therapeutic device of claim 1 , wherein the side wall includes flexible material providing the external surface.

3. The heart valve therapeutic device of claim 2 , wherein the flexible material is expandable to provide a compliant surface for coapting with the native leaflets.

4. The heart valve therapeutic device of claim 1 , wherein the coaptation assist valve comprises a distal structure and a proximal structure arranged to support the distal and proximal ends of the coaptation assist valve.

5. The heart valve therapeutic device of claim 4 , wherein the distal structure and/or the proximal structure comprises a ring.

6. The heart valve therapeutic device of claim 4 , wherein the distal structure and the proximal structure are included in an integral frame.

7. The heart valve therapeutic device of claim 4 , wherein the distal structure and/or the proximal structure comprises spokes.

8. The heart valve therapeutic device of claim 4 , wherein the distal structure and/or the proximal structure comprises a scallop-shaped member.

9. The heart valve therapeutic device of claim 1 , wherein the prosthetic valve is positioned at or near the proximal end of the coaptation assist valve.

10. The heart valve therapeutic device of claim 1 , wherein the prosthetic valve comprises a plurality of prosthetic leaflets mounted within the conduit, and wherein the prosthetic leaflets include a common material as at least part of the side wall.

11. The heart valve therapeutic device of claim 1 , wherein the support comprises an elongate rail and at least one connector connecting the coaptation assist valve to the elongate rail.

12. The heart valve therapeutic device of claim 1 , wherein the support comprises a support rail configured to suspend the conduit across the native heart valve without anchoring of the device to an annulus of the native heart valve or atrial or ventricular tissue adjacent to the native heart valve.

13. The heart valve therapeutic device of claim 12 , wherein the support rail is configured to extend percutaneously into a blood vessel coupled to the heart.

14. The heart valve therapeutic device of claim 1 , wherein the support extends through the coaptation assist valve.

15. The heart valve therapeutic device of claim 1 , wherein the support comprises a rail and the rail has a proximal end configured for subcutaneous implantation.

16. The heart valve therapeutic device of claim 1 , wherein the support is steerable and lockable.

17. The heart valve therapeutic device of claim 1 , wherein the support comprises a support rail and a guide tube arranged to maintain a shape of the support.

18. The heart valve therapeutic device of claim 17 , wherein the support rail ( 352 ) is configured to be disposed within the guide tube.

19. The heart valve therapeutic device of claim 18 , wherein the support comprises another tube and the guide tube and the support rail are configured to be disposed in the other tube.

20. The heart valve therapeutic device of claim 17 , wherein a distal portion of the support rail extends distally of the distal end of the guide tube to suspend the conduit across the native heart valve in use.

21. The heart valve therapeutic device of claim 17 , wherein the guide tube comprises telescopic tubing for advancing or retracting the conduit.

22. The heart valve therapeutic device of claim 1 , wherein the support comprises a rail and a guide to maintain a shape of the rail, and a lock configured to engage the guide to the rail.

23. The heart valve therapeutic device of claim 1 , further comprising a stabilization element arranged to hold the support at a particular radial location, thereby biasing at least part of the support towards the radial location.

24. The heart valve therapeutic device of claim 1 , further comprising a stabilization element arranged to limit radial, axial and/or rotational movement of the support.

25. The heart valve therapeutic device of claim 1 , further comprising a stent structure configured to engage an inner wall of a blood vessel coupled to the heart, the stent structure coupled to the support.

26. The heart valve therapeutic device of claim 25 , wherein the stent structure is coupled to a stent tube configured to receive the support.

27. The heart valve therapeutic device of claim 26 , wherein the support comprises an elongate support rail, a guide tube, and another tube, wherein the elongate support rail is configured to be disposed within the guide tube and the guide tube is configured to be disposed in the other tube.

28. The heart valve therapeutic device of claim 25 , further comprising a fixation element adapted to limit movement of the stent structure relative to the conduit, but is not fixed to the patient's body.

29. The heart valve therapeutic device of claim 1 , further comprising a fixation element configured to limit movement of the coaptation assist valve, wherein the fixation element comprises a collet.

30. A method of using a heart valve therapeutic device positioned across a patient's native heart valve, the method comprising:

implanting a coaptation assist valve comprising a conduit coupled to a support such that the conduit is configured to reside across the native heart valve, the coaptation assist valve comprising a prosthetic valve mounted within the conduit, wherein the conduit has a proximal end and a distal end;

allowing blood flow through a channel within the conduit via the prosthetic valve when the native heart valve opens; and

coapting an external surface of a side wall of the conduit with native leaflets of the native heart valve when the native heart valve closes,

wherein the side wall is unsupported between the distal end and the proximal end.