Trans-septal delivery system and methods of use
A delivery system for delivering a heart valve prosthesis includes a heart valve prosthesis and a delivery catheter. The heart valve prosthesis includes an anchoring member and an inner valve support, and further includes a radially collapsed configuration and a radially expanded configuration. The delivery catheter includes a handle, an outer shaft, an intermediate shaft, an inner shaft, and a distal tip component. The delivery catheter further includes a delivery configuration. In the delivery configuration, the outer shaft of the delivery catheter is configured to retain a first portion of the anchoring member, the intermediate shaft is configured to retain a first portion of the inner valve support, and the distal tip component is configured to retain a second end of the anchoring member and a second end of the inner valve support each in a radially compressed state.
1 . A method of delivering and deploying a heart valve prosthesis, the method comprising:
positioning a delivery catheter at a site of a native heart valve with the heart valve prosthesis in a radially compressed configuration within the delivery catheter, wherein the heart valve prosthesis includes an outer member coupled to an inner member and a prosthetic valve coupled to the inner member, wherein the delivery catheter includes an outer shaft, an intermediate shaft, and an inner shaft;
retracting the outer shaft to release the outer member of the heart valve prosthesis from the outer shaft such that the outer member radially expands;
after the step of retracting the outer shaft, advancing the delivery catheter such that a brim of the outer member engages an upstream side of an annulus of the native heart valve; and
after the step of advancing the delivery catheter, retracting the intermediate shaft to release the inner member of the heart valve prosthesis from the intermediate shaft such that the inner member radially expands.
2 . The method of claim 1 , wherein the native heart valve is an atrioventricular valve, and wherein the brim engages the atrial side of the annulus of the native heart valve.
3 . The method of claim 2 , wherein the native heart valve is a mitral valve.
4 . The method of claim 3 , wherein positioning the delivery catheter at the site of a native heart valve comprises advancing the delivery catheter from a right atrium to a left atrium via a puncture in a septal wall.
5 . The method of claim 2 , wherein the native heart valve is a tricuspid valve.
6 . The method of claim 1 , wherein an inflow portion of the heart valve prosthesis faces a proximal portion of the delivery catheter.
7 . The method of claim 1 , wherein the delivery catheter further includes a distal tip component coupled to a distal portion of the inner shaft, the distal tip component including a distal shaft component extending proximally from the distal tip component, wherein in the delivery configuration the distal shaft component encircles an outflow portion of the heart valve prosthesis, further comprising:
after the step of retracting the intermediate shaft, distally advancing the inner shaft to distally advance the distal shaft component to release the outflow portion of the heart valve prosthesis from the distal shaft component such that the outflow portion of the heart valve prosthesis radially expands.
8 . A method of delivering and deploying a heart valve prosthesis, the method comprising:
positioning a delivery catheter at a site of a native heart valve with the heart valve prosthesis in a radially compressed configuration within the delivery catheter, wherein the heart valve prosthesis includes an outer member coupled to an inner member and a prosthetic valve coupled to the inner member, wherein the delivery catheter includes an outer shaft, an intermediate shaft, an inner shaft, and a distal tip component coupled to a distal portion of the inner shaft, the distal tip component including a distal shaft component extending proximally from the distal tip component, wherein in the delivery configuration the distal shaft component encircles an outflow portion of the heart valve prosthesis;
retracting the outer shaft to release the outer member of the heart valve prosthesis from the outer shaft such that the outer member radially expands;
retracting the intermediate shaft to release the inner member of the heart valve prosthesis from the intermediate shaft such that the inner member radially expands; and
advancing the inner shaft to distally advance the distal shaft component to release the outflow portion of the heart valve prosthesis from the distal shaft component such that the outflow portion of the heart valve prosthesis radially expands.
9 . The method of claim 8 , further comprising, after the step of retracting the outer shaft, advancing the delivery catheter such that a brim of the outer member engages and upstream side of an annulus of the native heart valve.
10 . The method of claim 9 , wherein the native heart valve is an atrioventricular valve, and wherein the brim engages the atrial side of the annulus of the native heart valve.
11 . The method of claim 10 , wherein the native heart valve is a mitral valve.
12 . The method of claim 11 , wherein positioning the delivery catheter at the site of a native heart valve comprises advancing the delivery catheter from a right atrium to a left atrium via a puncture in a septal wall.
13 . The method of claim 10 , wherein the native heart valve is a tricuspid valve.