Methods and systems for cardiac valve delivery

Abstract

The present invention provides systems and methods for the repair, removal, and/or replacement of heart valves. The methods comprise introducing a delivery system into the heart, wherein a prosthesis is disposed on the delivery member attached to the delivery system, advancing the prosthesis to the target site, and disengaging the prosthesis from the delivery member at the target site for implantation. The present invention also provides implant systems for delivering a prosthesis to a target site in or near the heart. In one embodiment of the present invention, the implant system comprises a delivery system, an access system, and a prosthesis.

1 - 52 . (canceled) 
     
     
         53 . A delivery system comprising:
 an elongated, rigid support structure;   a delivery member coupled to the support structure at a distal portion of the support structure;   a valve replacement detachably positioned about the delivery member and configured to be collapsed to temporarily reduce a valve diameter, the valve replacement comprising a pliant prosthetic valve having an inlet end, an outlet end, a plurality of leaflet portions, and a plurality of commissural tabs positioned at the outlet end and integrally formed with the leaflet portions; and   a collapsible, self-expanding stent positioned about an exterior of the valve, the stent having a circular inflow rim and a circular outflow rim connected by a plurality of longitudinal support posts, the commissural tabs operably coupled to the longitudinal support posts,   wherein the rigid support structure is configured to transmit longitudinal and rotational motion along its length without twisting or bending along its length,   wherein the delivery member comprises a perfusion tube connecting a distal end and a proximal end of the delivery member configured to allow blood flow through the delivery member, and   wherein the rigid support structure terminates between the proximal end of the delivery member and the distal end of the delivery member.   
     
     
         54 . The delivery system of  claim 53 , wherein the self-expanding stent comprises a shape memory alloy. 
     
     
         55 . The delivery system of  claim 54 , wherein the shape memory alloy is Nitinol. 
     
     
         56 . The delivery system of  claim 53 , wherein the rigid support structure is selected from the group consisting of a solid rod, a hollow rod, a catheter with a guide stick, and a catheter with a guide sleeve. 
     
     
         57 . The delivery system of  claim 53 , wherein the delivery member comprises a proximal portion, a middle portion, and a distal portion, and
 wherein a cross-sectional area of the proximal portion and a cross-sectional area of the distal portion are each greater than a cross-sectional area of the middle portion.   
     
     
         58 . The delivery system of  claim 57 , wherein the valve replacement is disposed about the middle portion of the delivery member. 
     
     
         59 . The delivery system of  claim 53 , wherein the valve replacement is configured to be compressed to reduce the valve diameter by up to about 90%. 
     
     
         60 . The delivery system of  claim 53 , further comprising a delivery sleeve disposed about the delivery member. 
     
     
         61 . A scapus delivery system comprising:
 an elongated, rigid scapus; and   a delivery member positioned about the scapus,   wherein the delivery member comprises a perfusion tube connecting a distal end and a proximal end of the delivery member configured to allow blood flow through the delivery member, and   wherein the scapus terminates between the proximal end of the delivery member and the distal end of the delivery member.   
     
     
         62 . The delivery system of  claim 61 , further comprising a prosthetic valve positioned about the delivery member, the prosthetic valve comprising:
 a collapsible, self-expanding stent; and   a plurality of leaflets.   
     
     
         63 . The delivery system of  claim 62 , wherein the prosthetic valve is contained by the delivery member. 
     
     
         64 . The delivery system of  claim 62 , further comprising a delivery sleeve disposed about the delivery member. 
     
     
         65 . The delivery system of  claim 61 , wherein the scapus extends within the perfusion tube. 
     
     
         66 . A delivery system comprising:
 an elongated, rigid support structure;   a perfusion tube attached to the support structure;   a delivery member disposed around the perfusion tube; and   a prosthetic valve positioned about the delivery member, the prosthetic valve comprising:   a collapsible, self-expanding stent; and   a plurality of leaflets;   wherein the perfusion tube extends from a proximal end to a distal end of the delivery member and is configured to allow blood flow through the delivery member, and   wherein the rigid support structure terminates between the proximal end and the distal end of the delivery member.   
     
     
         67 . The delivery system of  claim 66 , wherein the prosthetic valve is crimped onto the delivery member. 
     
     
         68 . The delivery system of  claim 66 , further comprising a delivery sleeve disposed about the delivery member. 
     
     
         69 . The delivery system of  claim 66 , wherein the support structure is attached to an exterior surface of the perfusion tube. 
     
     
         70 . The delivery system of  claim 66 , wherein the delivery member comprises a proximal portion, a middle portion, and a distal portion,
 wherein a cross-sectional area of the proximal portion and a cross-sectional area of the distal portion are each greater than a cross-sectional area of the middle portion, and   wherein the valve replacement is disposed about the middle portion of the delivery member.   
     
     
         71 . The delivery system of  claim 66 , wherein the support structure comprises a material that substantially resists bending and torsion. 
     
     
         72 . The delivery system of  claim 66 , wherein the delivery member comprises one or more holes at the proximal end and one or more holes at the distal end to allow blood flow through the perfusion tube.