Systems and methods for transcatheter aortic valve treatment
Devices and methods are configured to allow transcarotid or subclavian access via the common carotid artery to the native aortic valve, and implantation of a prosthetic aortic valve into the heart. The devices and methods also provide means for embolic protection during such an endovascular aortic valve implantation procedure.
1. A system for transcatheter aortic valve treatment, comprising:
an arterial access sheath adapted to be introduced into an access site at the left or right carotid artery, or left or right subclavian artery,
wherein the arterial access sheath has a first lumen configured to receive a valve delivery system, the valve delivery system configured to deliver a prosthetic valve into a heart or aorta through the arterial access sheath, the first lumen having a first opening at a proximal end of the arterial access sheath and a distal opening at a distal most end of the arterial access sheath;
wherein the arterial access sheath further has a perfusion lumen with a proximal end and a distal opening and wherein the perfusion lumen has a length such that the distal opening of the perfusion lumen can be positioned in and perfuse an artery when in use;
an elongated body having a shunt lumen, the elongated body configured to fluidly connect an external source of perfusion fluid to the perfusion lumen of the arterial access sheath, wherein the elongated body receives perfusion fluid only from a source of perfusion fluid other than the arterial access sheath; and
the valve delivery system, wherein the valve delivery system fits within the first lumen of the arterial access sheath.
2. A system as in claim 1 , wherein the distal opening of the perfusion lumen has a radiopaque marker.
3. A system as in claim 1 , wherein the arterial blood source comprises a sheath in a femoral artery.
4. A system as in claim 1 , wherein the shunt incorporates an active pump.
5. A system as in claim 1 , wherein the shunt further comprises an in-line filter.
6. A system as in claim 1 , wherein the access sheath further comprises an occlusion balloon at a distal end of the access sheath.
7. A system as in claim 1 , wherein the shunt does not include a filter.
8. A system as in claim 1 , wherein the artery that is perfused is the carotid artery.
9. A system as in claim 1 , wherein the proximal end of the first lumen has a proximal connector with a hemostasis valve and a Y-arm, and wherein the hemostasis valve is sized to fit therethrough the valve delivery system.
10. A system as in claim 1 , wherein the valve delivery system includes:
an inner shaft;
an outer sleeve co-axially aligned with the inner shaft and slidably positioned over the inner shaft;
a prosthetic aortic valve removably mounted on the inner shaft; and
an actuator coupled to the outer shaft, wherein the actuator can be actuated to retract the outer shaft from a first position to a second position that exposes the prosthetic aortic valve.
11. A system as in claim 10 , wherein the valve delivery system has an entire length between 45 cm and 60 cm.