Devices and methods for transcatheter heart valve delivery
A delivery device for a collapsible prosthetic heart valve includes an operating handle and a catheter assembly. The operating handle may include a housing defining a movement space therein, a carriage assembly moveable in a longitudinal direction within the movement space, a deployment actuator coupled to the housing and rotatable relative to the housing, and a coupling assembly rotationally fixed to the deployment actuator. The catheter assembly may include a first shaft around which a compartment is defined and a distal sheath operatively connected to the carriage assembly. Movement of the carriage assembly in the longitudinal direction in the movement space may move the distal sheath between the closed condition and the open condition. The coupling assembly may have an engaged position in which rotation of the deployment actuator moves the carriage assembly, and a disengaged position in which rotation of the deployment actuator does not move the carriage assembly.
1. A delivery device for a collapsible prosthetic heart valve, the delivery device comprising:
an operating handle, including:
a housing defining a movement space therein;
a carriage assembly moveable in a longitudinal direction within the movement space, the carriage assembly being surrounded by the housing and being movable relative to the housing between distalmost and proximalmost positions within the housing;
a deployment actuator coupled to the housing and rotatable relative to the housing, the deployment actuator being disposed within a pocket extending within a middle portion of the housing; and
a coupling assembly rotationally fixed to the deployment actuator, the coupling assembly having an engaged position in which rotation of the deployment actuator moves the carriage assembly in the longitudinal direction, and a disengaged position in which rotation of the deployment actuator in a first direction and in a second direction opposite the first direction does not move the carriage assembly in the longitudinal direction; and
a catheter assembly, including:
a first shaft around which a compartment is defined, the first shaft being operatively connected to the housing, the compartment being adapted to receive the valve in an assembled condition; and
a distal sheath operatively connected to the carriage assembly, the distal sheath being moveable between a closed condition covering the compartment and an open condition uncovering the compartment for deployment of the valve,
wherein movement of the carriage assembly in the longitudinal direction in the movement space moves the distal sheath between the closed condition and the open condition.
2. The delivery device of claim 1 , wherein the carriage assembly includes a threaded rod extending from a body of the carriage assembly and into threaded engagement with the coupling assembly.
3. The delivery device of claim 2 , wherein rotation of the deployment actuator in the first direction moves the carriage assembly proximally in the longitudinal direction in the movement space, and rotation of the deployment actuator in the second direction moves the carriage assembly distally in the longitudinal direction in the movement space.
4. The delivery device of claim 2 , wherein the coupling assembly includes a split nut having a plurality of threaded split nut portions, the split nut portions each being linearly slideable away from one another and away from the threaded rod, the split nut having an engaged position in which threads of the split nut portions are engaged with the threaded rod and a disengaged position in which the threads of the split nut portions do not engage the threaded rod.
5. The delivery device of claim 4 , wherein the coupling assembly includes a ring coupled to the split nut portions, the ring having cam surfaces, the split nut portions being slideable along the cam surfaces when the split nut portions move between the engaged and disengaged positions.
6. The delivery device of claim 2 , wherein the deployment actuator is a knob rotatable about a central axis that extends parallel to the longitudinal direction.
7. The delivery device of claim 1 , wherein the carriage assembly includes a toothed rack extending from a body of the carriage assembly and into threaded engagement with the coupling assembly.
8. The delivery device of claim 1 , wherein the deployment actuator is a knob rotatable about a central axis that extends perpendicular to the longitudinal direction.
9. The delivery device of claim 1 , wherein the catheter assembly further includes an outer shaft attached to the distal sheath and operatively connected to the carriage assembly, the outer shaft at least partially surrounding the first shaft.
10. The delivery device of claim 1 , wherein the operating handle further includes a mechanism adapted to move the first shaft proximally relative to the housing.
11. The delivery device of claim 1 , wherein the first shaft is attached to the distal sheath and operatively connected to the carriage assembly, the catheter assembly further including an outer shaft connecting the housing to the compartment and at least partially surrounding the first shaft.
12. An operating handle for a delivery device for a collapsible prosthetic heart valve, the operating handle comprising:
a housing defining a movement space therein, a first shaft being operatively connected to the housing;
a carriage assembly moveable in a longitudinal direction within the movement space, a second shaft being cooperatively connected to the carriage assembly, the first shaft and the second shaft being arranged coaxially with one another;
a deployment actuator coupled to the housing and rotatable relative to the housing; and
a coupling assembly rotationally fixed to the deployment actuator, the coupling assembly having an engaged position in which rotation of the deployment actuator moves the carriage assembly in the longitudinal direction, and a disengaged position in which rotation of the deployment actuator does not move the carriage assembly in the longitudinal direction; and
wherein movement of the carriage assembly in the longitudinal direction in the movement space moves the second shaft relative to the first shaft,
wherein the carriage assembly includes a threaded rod extending from a body of the carriage assembly and into threaded engagement with the coupling assembly, and
wherein the coupling assembly includes a split nut having a plurality of threaded split nut portions, the split nut having an engaged position in which threads of the split nut portions are engaged with the threaded rod and a disengaged position in which the threads of the split nut portions do not engage the threaded rod.
13. The operating handle of claim 12 , wherein rotation of the deployment actuator in a first direction moves the carriage assembly proximally in the longitudinal direction in the movement space, and rotation of the deployment actuator in a second direction moves the carriage assembly distally in the longitudinal direction in the movement space.
14. The operating handle of claim 12 , wherein the split nut portions each are linearly slideable away from one another and away from the threaded rod.
15. The operating handle of claim 12 , wherein the coupling assembly includes a ring coupled to the split nut portions, the ring having cam surfaces, the split nut portions being slideable along the cam surfaces when the split nut portions move between the engaged and disengaged positions.
16. The operating handle of claim 12 , wherein the deployment actuator is a knob rotatable about a central axis that extends parallel to the longitudinal direction.