Abstract: A method for improving blood flow in a patient who has undergone a first heart valve replacement procedure followed by a second heart valve replacement procedure is disclosed. The method includes positioning a second prosthetic replacement valve to replace a primary prosthetic replacement valve within the patient, providing a laser fenestration system including a laser fiber, guiding the laser fiber through the patient's circulatory system to the second prosthetic replacement valve, performing a laser ablation process using the laser fiber to remove portions of a leaflet tissue between any stent structure of the primary prosthetic replacement valve, removing the laser fiber from the patient's circulatory system, and finalizing the second prosthetic valve replacement procedure. In embodiments, the method includes removing native leaflet tissue using laser ablation. In embodiments, a fenestration system for implementing the described method is disclosed.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.

Abstract: A method for optimizing a shape of a replacement valve leaflet, wherein the shape of the replacement valve leaflet is determined by defining variable parameters of the replacement valve leaflet. The variable parameters may comprise: a valve height; a leaflet coaptation height, a first set of two control points for a first B-spline plane of symmetry; and a second set of two control points for a second B-spline plane tangent to a frame of the valve. The method may further comprise creating iterations of potential shapes of the replacement valve leaflet by changing one or more of the variable parameters using modeling software. The method may also comprise calculating the maximum stresses or strains on each of the potential shapes.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.

Abstract: A method for optimizing a shape of a replacement valve leaflet, wherein the shape of the replacement valve leaflet is determined by defining variable parameters of the replacement valve leaflet. The variable parameters may comprise: a valve height; a leaflet coaptation height, a first set of two control points for a first B-spline plane of symmetry; and a second set of two control points for a second B-spline plane tangent to a frame of the valve. The method may further comprise creating iterations of potential shapes of the replacement valve leaflet by changing one or more of the variable parameters using modeling software. The method may also comprise calculating the maximum stresses or strains on each of the potential shapes.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially if needed and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.

Abstract: A prosthetic aortic valve intended for native or valve-in-valve within bioprostheses includes an expandable support scaffold and valve leaflets disposed within an upper leaflet portion of the support scaffold. The valve leaflets within the upper portion may be located within the annulus (intravalvular), above the annulus, or above the native or prosthetic leaflets (supravalvular). The valve within a previously implanted degenerated heart valve such that a base or lower portion of the replacement valve is within the previously implanted valve and the upper portion is expanded within the aorta, the internal area of the valve can be increased and the hemodynamics of the valve improved. Alternatively, the valve may include separate upper and lower portions allowing the portions to be implanted sequentially and the length and other characteristics of the valve to be adjusted based on patient anatomy and condition.