Abstract: Embodiments of the present disclosure provide a prosthetic heart valve usable with a heart valve delivery apparatus for delivery of the prosthetic heart valve to a native valve site via the human vasculature. In one embodiment, a self-expanding valve comprises an expandable stent that is shaped to maintain the valve in the aortic annulus against axial without anchors or retaining devices that engage the surrounding tissue.

Abstract: Disclosed replacement heart valves can be designed to be delivered to a native valve site while crimped on a delivery catheter. The crimped profile of the replacement valve can be minimized by, for example, separating a frame or stent structure from a leaflet structure, along the axial direction. Disclosed replacement valves can be transitioned from a delivery configuration, in which the crimped profile can be minimized, to an operating configuration. The replacement valve can be fully assembled in both the delivery and operating configurations. In some embodiments, the leaflets can be positioned outside of the stent in the delivery configuration, and positioned inside of the stent lumen in the operating configuration. Disclosed replacement valves can include a flexible sleeve coupling the leaflets to the stent and facilitating the transition to the operating configuration. Methods of implanting said replacement valves are also disclosed.

Abstract: A method of crimping an implantable prosthetic valve can include placing protective material over at least a portion of the implantable prosthetic valve. The protective material can be configured to occupy space between open cells of a frame of the implantable prosthetic valve to prevent damage to a leaflet structure of the implantable prosthetic valve. The method can also include crimping the implantable prosthetic valve with the protective material on the implantable prosthetic valve, and removing the protective material from between the frame and the leaflet structure of the implantable prosthetic valve.

Abstract: A system for replacing a deficient native aortic valve includes an implantable prosthetic valve having a self-expandable frame and a valve assembly formed with three valve leaflets. The self-expandable frame includes a plurality of support beams, each support beam having a plurality of preformed bores for allowing the valve assembly to be anchored to the frame at least in part by stitching that extends through the leaflets and through the preformed bores of the support beams. The system also includes a restriction tube adapted for insertion into a patient's body. The prosthetic valve is capable of being crimped for insertion into the restriction tube and capable of self-expansion upon release from the restriction tube for deployment in the deficient native aortic valve.

Abstract: Disclosed replacement heart valves can be designed to be delivered to a native valve site while crimped on a delivery catheter. The crimped profile of the replacement valve can be minimized by, for example, separating a frame or stent structure from a leaflet structure, along the axial direction. Disclosed replacement valves can be transitioned from a delivery configuration, in which the crimped profile can be minimized, to an operating configuration. The replacement valve can be fully assembled in both the delivery and operating configurations. In some embodiments, the leaflets can be positioned outside of the stent in the delivery configuration, and positioned inside of the stent lumen in the operating configuration. Disclosed replacement valves can include a flexible sleeve coupling the leaflets to the stent and facilitating the transition to the operating configuration. Methods of implanting said replacement valves are also disclosed.

Abstract: A prosthetic heart valve can comprise a radially collapsible and expandable annular frame and a leaflet structure comprising a plurality of leaflets mounted within the frame. The frame can have commissure attachment portions that are configured to support the commissures of the leaflets in unique ways. For example, commissure attachment portions can include at least two struts defining a gap therebetween. Additionaly, angularly-spaced commissure attachment portions can comprise inner struts and outer struts. Adjacent side portions of leaflets can extend through a gap between the inner struts of a corresponding commissure attachment portion. Further features and arrangements are also possible.

Abstract: A system for delivering pressurized fracking fluid to a well includes a high-pressure pump pumping proppant-free fluid, and a double-piston pressure transfer arrangement for transferring pressure from the proppant-free fluid to a fracking fluid. The pressure transfer arrangement includes first and second cylinder assemblies, each having a piston in sliding engagement within a first hollow cylinder so as to define first and second chambers of the first cylinder and third and fourth chambers of the second cylinder. A piston rod interconnects the pistons. A flow selector alternately directs high-pressure proppant-free fluid to the first chamber and the third chamber so as to act on the pistons, thereby applying pressure to fracking fluid within the second and fourth chambers, respectively, for delivery to the well in alternate power strokes.

Abstract: A prosthetic heart valve according to the present disclosure comprises a radially collapsible and expandable annular frame and a leaflet structure comprising a plurality of leaflets mounted within the frame. The frame in particular embodiments can have commissure attachment portions that are configured to support the commissures of the leaflets at locations spaced radially inwardly toward the longitudinal flow axis of the prosthetic valve relative to the frame portions circumscribing the moveable portions of the leaflets. When the leaflets open under pressure of blood flowing through the prosthetic valve, the moveable portions of the leaflets are retained at positions spaced inwardly from the inner surface of the frame to protect against abrasion of the leaflets.

Abstract: A method of crimping an implantable prosthetic valve can include placing protective material over at least a portion of the implantable prosthetic valve. The protective material can be configured to occupy space between open cells of a frame of the implantable prosthetic valve to prevent damage to a leaflet structure of the implantable prosthetic valve. The method can also include crimping the implantable prosthetic valve with the protective material on the implantable prosthetic valve, and removing the protective material from between the frame and the leaflet structure of the implantable prosthetic valve.

Abstract: A system for replacing a deficient native aortic valve includes an implantable prosthetic valve having a self-expandable frame and a valve assembly formed with three valve leaflets. The self-expandable frame includes a plurality of support beams, each support beam having a plurality of preformed bores for allowing the valve assembly to be anchored to the frame at least in part by stitching that extends through the leaflets and through the preformed bores of the support beams. The system also includes a restriction tube adapted for insertion into a patient's body. The prosthetic valve is capable of being crimped for insertion into the restriction tube and capable of self-expansion upon release from the restriction tube for deployment in the deficient native aortic valve.

Abstract: This application relates to methods, systems, and apparatus for replacing native heart valves with prosthetic heart valves and treating valvular insufficiency. In a representative embodiment, a support frame configured to be implanted in a heart valve comprises an annular main body formed by a plurality of angled struts, the main body including a plurality of peaks formed by the intersection of respective adjacent struts. The support frame further comprises one or more leaflet-engaging mechanisms configured to engage leaflets of the heart valve. The support frame can be radially expandable and collapsible.

Abstract: A prosthetic heart valve comprises a radially crimpable and radially expandable, net-like, annular support frame and a valve assembly disposed therein, the valve assembly comprising a conduit tapering from an inlet towards an outlet thereof. Some embodiments or the support frame comprise a proximal portion and a distal portion, a diameter of the proximal portion smaller than a diameter of the distal portion. The proximal portion is dimensioned for deployment in an annulus of a native aortic valve and a distal portion for deployment in an ascending aorta. Some embodiments of the conduit comprise a support construction with a three-cusp, crown-shaped cut line, the support construction sutured to the support frame around a bottom portion thereof and around the cut line. A method for using the prosthetic heart valve to replace a defective native aortic valve uses a minimally invasive procedure.

Abstract: An implantable prosthetic valve, according to one embodiment, comprises a frame, a leaflet structure, and a skirt member. The frame can have a plurality of axial struts interconnected by a plurality of circumferential struts. The leaflet structure comprises a plurality of leaflets (e.g., three leaflets arrange to form a tricuspid valve). The leaflet structure has a scalloped lower edge portion secured to the frame. The skirt member can be disposed between the leaflet structure and the frame.

Abstract: A two-stage or component-based valve prosthesis that can be quickly and easily implanted during a surgical procedure is provided. The prosthetic valve comprises a support structure that is deployed at a treatment site. The prosthetic valve further comprises a valve member configured to be quickly connected to the support structure. The support structure may take the form of a stent that is expanded at the site of a native valve. If desired, the native leaflets may remain and the stent may be used to hold the native valve open. In this case, the stent may be balloon expandable and configured to resist the powerful recoil force of the native leaflets. The support structure is provided with a coupling means for attachment to the valve member, thereby fixing the position of the valve member in the body. The valve member may be a non-expandable type, or may be expandable from a compressed state to an expanded state.

Abstract: A prosthetic heart valve assembly suitable for implantation in body ducts via a catheter. The prosthetic heart valve assembly includes a collapsible and expandable tubular frame having an inlet end and an outlet end. The frame is preferably made from a self-expanding material. Three pericardial leaflets form a tricuspid valve having a top portion, a middle portion, and a bottom portion. Three longitudinal support members are positioned along an internal surface of the frame, desirably proximate to the outlet end. Each support member includes a pair of longitudinal surfaces that extends radially inwardly. End portions of adjacent valve leaflets extend through a gap between the pairs of longitudinal surfaces of each support member. The end portions are sutured to the longitudinal support members. The bottom portion of the tricuspid valve is sutured to the inlet end of the frame.

Abstract: This application relates to methods, systems, and apparatus for replacing native heart valves with prosthetic heart valves and treating valvular insufficiency. In a representative embodiment, a support frame configured to be implanted in a heart valve comprises an annular main body formed by a plurality of angled struts, the main body including a plurality of peaks formed by the intersection of respective adjacent struts. The support frame further comprises one or more leaflet-engaging mechanisms configured to engage leaflets of the heart valve. The support frame can be radially expandable and collapsible.

Abstract: A prosthesic valve for implantation in a body duct that can cover a range of target sizes by a single device. The valve comprises of three main elements: 1) a support cylindrical frame structure that can be collapsed to a small diameter for insertion into the body and that can expand to a large diameter when positioned in the target implantation site, the expansion of the frame being limited by the native valve diameter, which the valve is implanted within. In some cases this may be self-expandable; 2) A frustoconical leaflet support frame that has an inflow side and an outflow side.

Abstract: An implantable prosthetic valve has an upper frame section and a lower frame section. The upper frame section has a plurality of struts and a first leaflet receiving surface at a lower portion of the upper frame section. The lower frame section has a second leaflet receiving surface at an upper portion of the lower frame section. An edge of a flexible leaflet is disposed between the first and second leaflet receiving surfaces to attach the leaflet to the upper and lower frame sections.

Abstract: A heart valve prosthesis that can be quickly and easily implanted during a surgical procedure is provided. The prosthetic valve comprises a support structure that is deployed at a treatment site. The prosthetic valve further comprises a valve member configured to be quickly connected to the support structure. The support structure may take the form of a stent that is expanded at the site of a native valve. If desired, the native leaflets may remain and the stent may be used to hold the native valve open. In this case, the stent may be balloon expandable and configured to resist the powerful recoil force of the native leaflets. The support structure is provided with a coupling means for attachment to the valve member, thereby fixing the position of the valve member in the body. The valve member may be expandable or a non-expandable type.

Abstract: Embodiments of a radially collapsible and expandable prosthetic heart valve are disclosed. A valve frame can have a tapered profile when mounted on a delivery shaft, with an inflow end portion having a smaller diameter than an outflow end portion. The valve can comprise generally V-shaped leaflets, reducing material within the inflow end of the frame. An outer skirt can be secured to the outside of the inflow end portion of the frame, the outer skirt having longitudinal slack when the valve is expanded and lying flat against the frame when the valve is collapsed. A diagonally woven inner skirt can elongate axially with the frame. Side tabs of adjacent leaflets can extend through and be secured to window frame portions of the frame to form commissures. The window frame portions can be depressed radially inward relative to surrounding frame portions when the valve is crimped onto a delivery shaft.