Delivery and retrieval devices and methods for side-deliverable transcatheter prosthetic valves
A delivery system for side-delivery of a prosthetic valve includes a compression device defining a lumen having a first perimeter at a proximal end that is larger than a second perimeter of the lumen at a distal end. A loading device is coupleable to the compression device and defines a lumen having substantially the second perimeter. A distal end of the loading device includes a first gate that is movable between an open state and a closed state to at least partially occlude the lumen of the loading device. A delivery device defines a lumen having substantially the second perimeter. A proximal end of the delivery device is coupleable to the distal end of the loading device and includes a second gate movable between an open state and a closed state to at least partially occlude the lumen of the delivery device.
1. An apparatus for selectively engaging a side-deliverable transcatheter prosthetic valve, the apparatus comprising:
a multi-lumen catheter having a distal end and a proximal end;
a control portion coupled to the proximal end of the multi-lumen catheter;
a yoke coupled to the distal end of the multi-lumen catheter;
a first tether extendable through a first control arm of the control portion and a first lumen of the multi-lumen catheter such that each of a proximal end and a distal end of the first tether is proximal to the first control arm, a portion of the first tether configured to be looped through a first side of the yoke and around an attachment tether of the prosthetic valve to removably couple, at least in part, the yoke to the prosthetic valve;
a second tether extendable through a second control arm of the control portion and a second lumen of the multi-lumen catheter, a portion of the second tether configured to be looped through a second side of the yoke; and
a tension member extendable through a third control arm of the control portion and a third lumen of the multi-lumen catheter such that each of a proximal end and a distal end of the tension member is proximal to the third control arm, a portion of the tension member configured to be removably looped through a plurality of attachment points along a proximal subannular anchoring element of the prosthetic valve.
2. The apparatus of claim 1 , wherein a force exerted on each of the proximal end and the distal end of the first tether is operable to increase a tension along the first tether and secure the first side of the yoke to the prosthetic valve, and
wherein a force exerted on one of the proximal end or the distal end of the first tether is operable to (i) release the first side of the yoke from the first portion of the attachment tether of the prosthetic valve and (ii) withdraw the first tether from the first side of the yoke, the first lumen of the multi-lumen catheter, and the first control arm of the control portion.
3. The apparatus of claim 1 , wherein the second tether is configured to be looped through each of the second control arm, the second lumen of the multi-lumen catheter, and the second side of the yoke such that each of a proximal end and a distal end of the second tether is proximal to the second control arm,
the second tether is configured to be looped around a second portion of the attachment tether to removably couple the second side of the yoke to the prosthetic valve.
4. The apparatus of claim 3 , wherein a force exerted on each of the proximal end and the distal end of the second tether is operable to increase a tension along the second tether and secure the second side of the yoke to the prosthetic valve, and
wherein a force exerted on one of the proximal end or the distal end of the second tether is operable to (i) release the second side of the yoke from the second portion of the attachment tether of the prosthetic valve and (ii) withdraw the second tether from the second side of the yoke, the second lumen of the multi-lumen catheter, and the second control arm of the control portion.
5. The apparatus of claim 1 , wherein a force exerted on each of the proximal end and the distal end of the tension member is operable to increase a tension along the tension member, the tension along the tension member operable to transition the proximal subannular anchoring element from a first configuration to a second configuration, and
wherein a force exerted on one of the proximal end or the distal end of the tension member is operable to withdraw the tension member from the proximal subannular anchoring element, the third lumen of the multi-lumen catheter, and the third control arm of the control portion.
6. The apparatus of claim 5 , wherein the tension along the tension member is further operable to bow the distal end of the multi-lumen catheter in a supra-annular direction when (i) the tension exceeds a threshold amount of tension, and (ii) a tension along each of the first tether and the second tether secures the first side and the second side of the yoke, respectively, to the prosthetic valve.
7. The apparatus of claim 1 , wherein the multi-lumen catheter defines a fourth lumen and the control portion defines an opening in communication with the fourth lumen, the fourth lumen of the multi-lumen catheter and the opening defined by the control portion configured to receive a guidewire catheter such that a distal end of the guidewire catheter (i) is distal to the distal end of the multi-lumen catheter, (ii) extends through a waypoint of the prosthetic valve and below a flow control component of the prosthetic valve, and (iii) extends through a distal subannular anchoring element of the prosthetic valve.
8. An apparatus for selectively engaging a side-deliverable transcatheter prosthetic valve, the apparatus comprising:
a multi-lumen catheter having a distal end and a proximal end;
a control portion coupled to the proximal end of the multi-lumen catheter;
a yoke coupled to the distal end of the multi-lumen catheter;
a first tether extendable through a first control arm of the control portion and a first lumen of the multi-lumen catheter such that each of a proximal end and a distal end of the first tether is proximal to the first control arm, a portion of the first tether configured to be looped through a first side of the yoke and around a first portion of an attachment tether of the prosthetic valve to removably couple the first side of the yoke to the prosthetic valve;
a second tether extendable through a second control arm of the control portion and a second lumen of the multi-lumen catheter such that each of a proximal end and a distal end of the second tether is proximal to the second control arm, a portion of the second tether configured to be looped through a second side of the yoke and around a first portion of an attachment tether of the prosthetic valve to removably couple the first side of the yoke to the prosthetic valve; and
a tension member extendable through a third control arm of the control portion and a third lumen of the multi-lumen catheter such that each of a proximal end and a distal end of the tension member is proximal to the third control arm, a portion of the tension member configured to be removably looped through a plurality of attachment points along a proximal subannular anchoring element of the prosthetic valve.
9. The apparatus of claim 8 , wherein a force exerted on each of the proximal end and the distal end of the first tether is operable to increase a tension along the first tether and secure the first side of the yoke to the prosthetic valve, and
wherein a force exerted on one of the proximal end or the distal end of the first tether is operable to (i) release the first side of the yoke from the first portion of the attachment tether of the prosthetic valve and (ii) withdraw the first tether from the first side of the yoke, the first lumen of the multi-lumen catheter, and the first control arm of the control portion.
10. The apparatus of claim 9 , wherein a force exerted on each of the proximal end and the distal end of the second tether is operable to increase a tension along the second tether and secure the second side of the yoke to the prosthetic valve, and
wherein a force exerted on one of the proximal end or the distal end of the second tether is operable to (i) release the second side of the yoke from the second portion of the attachment tether of the prosthetic valve and (ii) withdraw the second tether from the second side of the yoke, the second lumen of the multi-lumen catheter, and the second control arm of the control portion.
11. The apparatus of claim 8 , wherein a force exerted on each of the proximal end and the distal end of the tension member is operable to increase a tension along the tension member, the tension along the tension member operable to transition the proximal subannular anchoring element from a first configuration to a second configuration, and
wherein a force exerted on one of the proximal end or the distal end of the tension member is operable to withdraw the tension member from the proximal subannular anchoring element, the third lumen of the multi-lumen catheter, and the third control arm of the control portion.
12. The apparatus of claim 11 , wherein the tension along the tension member is further operable to bow the distal end of the multi-lumen catheter in a supra-annular direction when (i) the tension exceeds a threshold amount of tension, and (ii) a tension along each of the first tether and the second tether secures the first side and the second side of the yoke, respectively, to the prosthetic valve.
13. The apparatus of claim 8 , wherein the multi-lumen catheter defines a fourth lumen and the control portion defines an opening in communication with the fourth lumen, the fourth lumen of the multi-lumen catheter and the opening defined by the control portion configured to receive a guidewire catheter such that a distal end of the guidewire catheter (i) is distal to the distal end of the multi-lumen catheter, (ii) extends through a waypoint of the prosthetic valve and below a flow control component of the prosthetic valve, and (iii) extends through a distal subannular anchoring element of the prosthetic valve.