Abstract: A delivery device includes a handle, a central elongate member extending from the handle, a sheath configured to slide over and relative to the central elongate member, a distal tether retainer at a distal end of the central elongate member, a proximal tether restraining mechanism positioned along the central elongate member distal of the handle and proximal of the distal tether retainer, and a plurality of tethers. The tethers are configured to extend from the proximal tether restraining mechanism to the distal tether retainer.

Abstract: A side-deliverable prosthetic valve includes an outer frame, a flow control component mounted within the outer frame, and an anchoring element coupled to a distal side of the outer frame. The prosthetic valve is foldable along a longitudinal axis and compressible along a central axis to a compressed configuration for side delivery via a delivery catheter and is expandable to an expanded configuration when released from the delivery catheter. An end portion of the anchoring element is configured to engage a guide wire. The anchoring element is extended during deployment to allow the anchoring element to capture at least one of native leaflet or chordae and, in response to the guide wire being disengaged from the end portion, transitions to a folded configuration to secure at least one of the native leaflet or the chordae between the anchoring element and the distal side of the outer frame.

Abstract: Disclosed herein are devices for improving coaption of the mitral valve leaflets to reduce or eliminate mitral valve regurgitation. The devices may be used to perform mitral valve annuloplasty, or to serve as a docking station for a transcatheter prosthetic heart valve. The various embodiments of devices are configured for percutaneous and, in some cases, transvascular delivery. Delivery systems useful for routing the devices to the mitral valve are also disclosed, including catheters, balloons and/or mechanical expansion systems. The devices themselves include at least one tissue penetrating member. Methods of delivery include partially embedding the devices in the mitral valve annulus via at least one tissue penetrating member. Tissue penetrating members may be embedded into the tissue in a simultaneous or a nearly simultaneous fashion. Upon embedding, the devices employ various expansion and/or contraction features to adjust the mitral valve diameter.

Abstract: A transcatheter atrio-ventricular valve prosthesis for functional replacement of an atrio-ventricular valve in a connection channel, having a circumferential connection channel wall structure, between atrial and ventricular chambers of a heart, including an inner device to be disposed in the interior of the connection channel, the inner device having a circumferential support structure which is radially expandable and having a valve attached to the circumferential support structure, and an outer device to be disposed on the exterior of the connection channel, wherein the outer device at least partly extends around the inner device at a radial distance to the inner device, wherein the inner and outer devices form a securing mechanism for securing the circumferential connection channel wall structure therebetween.

Abstract: The invention relates to a device for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation assistance element for implantation across the valve; a system including the coaptation assistance element and anchors for implantation; a system including the coaptation assistance element and delivery catheter; and a method for transcatheter implantation of a coaptation element across a heart valve.

Abstract: An assembly for the tricuspid orifice of a human heart, comprises an external frame connected to an internal stent carrying a tricuspid valve bioprosthesis and a sealing skirt. The external frame is configured to hold its position in the native tricuspid annulus. The internal stent is connected to the external frame by one or more fixing strands. The sealing skirt covers the interstitial space existing between the external frame and the internal stent. Developments are described which comprise in particular the use of a deformable region of the frame, various alternative embodiments of the sealing skirt, the use of a frame composed of multiple sub-sections, the use of fixing strands between the stent and the frame and of fixing elements for fixing the assembly to the native tissue, the use of sensors and/or actuators, and also the use of a stent in the inferior vena cava. Method aspects are described.

Abstract: Apparatus and methods are described herein for use in the transvascular delivery and deployment of a prosthetic heart valve. In some embodiments, an apparatus includes an outer sheath, a tube member movably disposed within the outer sheath, a retention device coupled to the tube member, and a valve holder. A prosthetic heart valve is disposed within the outer sheath and includes an outer frame and an inner frame that is removably coupled to the valve holder. The outer frame is disposed in an inverted configuration relative to the inner frame. A first actuation wire is releasably coupled to a first portion of the outer frame and releasably coupled to the retention device at a first location on the retention device. A second actuation wire is releasably coupled to a second portion of the outer frame and releasably coupled to the retention device at a second location on the retention device.

Abstract: A method of deploying a blood-flow controlling device is described for treating a native mitral or tricuspid valve. The blood-flow controlling device includes a blood-flow blocking portion that is slidable over an elongate body portion. The blood-flow blocking portion is preferably an elongate structure fillable with blood having a portion adapted for placement between leaflets of the native valve. An anchor is located on a distal end of the elongate body portion for engagement with heart tissue adjacent a heart apex. An anchor delivery catheter is advanced through the native valve and into an adjacent ventricle. The anchor is then expelled from the anchor delivery catheter into ventricular tissue. The blood-flow blocking portion is then slid along the elongate body portion and positioned between the native leaflets. A locking catheter is then slid along the elongate body portion for locking the blood-flow blocking portion to the elongate body portion.

Abstract: A mitral valve leaflet repair system may include a delivery catheter having at least one lumen extending proximally from a distal end of the delivery catheter, a plurality of anchor elements disposed within the at least one lumen, each of the plurality of anchor elements being configured to extend through one layer of mitral valve leaflet tissue, and a securing element configured to secure at least two of the plurality of anchor elements together on one side of the mitral valve leaflet tissue. The at least one lumen may include a suction lumen configured to grasp a mitral valve leaflet prior to extending the plurality of anchor elements through one layer of mitral valve leaflet tissue.

Abstract: A method for delivering a heart valve prosthesis to a native valve annulus comprises expanding an expandable frame at the native valve annulus and positioning a replacement heart valve within the expandable frame. The expandable frame preferably includes a first anchoring portion that is positioned on a first side of the native valve annulus and a second anchoring portion that is positioned on a second side of the native valve annulus. The first anchoring portion engages tissue on the first side of the native valve annulus and the second anchoring portion engages tissue on the second side of the native valve annulus for securing the expandable frame to the native valve annulus. The replacement heart valve comprises a plurality of leaflets for replacing the function of the native valve.

Abstract: A prosthetic heart valve for replacing a defective aortic valve includes a self-expandable annular frame made of shape-memory material. A one-way valve structure is disposed within an interior of the frame. The frame includes a plurality of posts projecting axially from an outflow end portion of the frame, wherein each of the posts includes an axial post portion and a terminal post portion. The terminal post portions have greater circumferential dimensions than the axial post portions. The terminal post portions are preferably formed with concave inner surfaces and convex outer surfaces for conforming to the shape of a delivery catheter. Each of the posts is shaped for placement within a corresponding recess along a distal end portion of the delivery catheter for ensuring that the prosthetic heart valve remains coupled to the delivery catheter while the prosthetic heart valve is expanded within the defective aortic valve.

Abstract: An implant delivery system is described, having a distal tip and outer sheath that remain in a fixed position during implant delivery. A pusher mechanism within the sheath pushes an implant out of a gap between a distal end of the sheath and the distal tip.

Abstract: An occluder device for occluding a gap between a medical device and adjacent body tissue includes a conformable body having a hollow interior, a leading end and a trailing end; and a port disposed at the trailing end of the body and in fluid communication with the interior of the body.

Abstract: This invention relates to the design and function of a compressible valve replacement prosthesis, collared or uncollared, which can be deployed into a beating heart without extracorporeal circulation using a transcatheter delivery system. The design as discussed focuses on the deployment of a device via a minimally invasive fashion and by way of example considers a minimally invasive surgical procedure preferably utilizing the intercostal or subxyphoid space for valve introduction. In order to accomplish this, the valve is formed in such a manner that it can be compressed to fit within a delivery system and secondarily ejected from the delivery system into the annulus of a target valve such as a mitral valve or tricuspid valve.

Abstract: The present application provides an implantation method of an artificial heart valve. The implantation method can include forming an incision in the left chest to expose the ventricle; advancing a guide wire kept away from chordae tendineaes through the atrium into the ventricle; advancing a guide wire catcher into the ventricle from the incision to pull out the distal end of the guide wire from the ventricle; and advancing the artificial heart valve into the ventricle from the distal end of the guide wire with a valve deliverer, and placing the artificial heart valve at a primary valve between the ventricle and the atrium along the guide wire. The artificial heart valve may avoid the chordae tendineaes in the heart system through the guide wire track during implantation.

Abstract: Methods, systems, and apparatuses for treating a heart are provided. Methods can include obtaining and using an implant. One or more catheters can be used to properly position and attach the implant in a desired location in a chamber of the heart, for example, on a ventricular wall of the left ventricle between one or more papillary muscles of the left ventricle and the annulus. Then a distance along the implant or a region of the heart, for example, between the papillary muscle and the annulus, can be reduced by contracting the implant along its longitudinal axis by applying tension to a contraction member of the implant. Other embodiments are described.

Abstract: A heart valve annulus repair device having a tissue engaging member and a plurality of anchors. The tissue engaging member includes a loop of wire. Each of the anchors has a pointy front end and a back end and a slot that runs in a front-to-back direction. The anchors are distributed about the loop of wire with the front ends of the plurality of anchors facing the heart valve annulus and with the loop of wire passing through the slots. The device further includes means for implanting the anchors into the heart valve annulus tissue so that the tissue engaging member becomes affixed to the heart valve annulus.

Abstract: This invention relates to the design and function of a compressible valve replacement prosthesis, collared or uncollared, which can be deployed into a beating heart without extracorporeal circulation using a transcatheter delivery system. The design as discussed focuses on the deployment of a device via a minimally invasive fashion and by way of example considers a minimally invasive surgical procedure preferably utilizing the intercostal or subxyphoid space for valve introduction. In order to accomplish this, the valve is formed in such a manner that it can be compressed to fit within a delivery system and secondarily ejected from the delivery system into the annulus of a target valve such as a mitral valve or tricuspid valve.

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.

Abstract: The present disclosure relates to heart valve prostheses, delivery devices, actuation handles, and other improved devices and methods that facilitate delivery of a heart valve prosthesis to a defective native valve structure in a patient, such as the aortic valve.

Abstract: A prosthetic system for heart valve replacement comprises an annular support structure within which a valved prosthetic body can be expanded until it meets opposition. The annular support is provided in ring segments having terminal connectors for forming, in the condition of use of the prosthetic system, a stable and durable annular structural continuity capable of withstanding the opposition exerted by the valved prosthetic body. The prosthetic system is deployed using guide wires within a cardiac chamber guided through an introducer catheter having through lumens, within which at least two first guide catheters are positioned. These guide catheters have respective deflected or deflectable distal ends adapted to emerge from the distal end of the introducer catheter to convey and direct the distal ends of respective guide wires, placed within the guide catheters, towards a capture member of a capture system which is provided within the introducer catheter.

Abstract: Embodiments hereof relate to centering devices for use with a valve delivery system and methods of delivering a valve prosthesis within a vasculature. A valve centering catheter is configured for use with a valve delivery system. The valve centering catheter includes a circumferential centering device at a distal portion thereof, and the circumferential centering device defines a central opening there-through when in an expanded configuration. The circumferential centering device is annular or has a C-shaped cross-section. The valve delivery system is tracked through the vasculature until the valve prosthesis is positioned through the central opening of the expanded circumferential centering device. The valve centering catheter may alternatively include a longitudinal centering device which acts as a marker for depth control during delivery of a valve delivery system, which may include an integral circumferential centering device.

Abstract: A paravalvular leak resistant prosthetic heart valve system including a stent frame, a valve structure and a sealing mechanism. The stent frame has a surface. The valve structure is associated with the stent frame. The sealing mechanism at least partially extends over the surface of the stent frame. The sealing mechanism includes at least one semi-permeable membrane and an osmotic gradient driving material.

Abstract: An implantable prosthetic device includes a coaption portion, paddles, and clasps. The paddles are extendable from a folded closed position to an open position. The clasps each have a fixed arm and a plurality of moveable arms each having a barbed portion. A plurality of hinge portions connect the moveable arms to the fixed arm.

Abstract: An implant for improving coaptation of an atrioventricular valve in which the atrioventricular valve has a first native leaflet, a second native leaflet and an annulus includes a support structure configured to be arranged on and fixed to the annulus or to at least one of the first and second native first leaflets. The implant also includes flexible retention structure mounted to the support structure so as to prevent prolapse of the at least one of the first and second native leaflets. A method for improving coaptation of such an atrioventricular valve is also disclosed.

Abstract: A prosthetic heart valve can include a support stent, a valve assembly, and a connection structure. The support stent can have an inlet end portion and an outlet end portion, and can be configured to be radially expandable from a crimped configuration to an expanded configuration. The valve assembly can have an inlet, an outlet, and a plurality of leaflets. The connection structure supports the valve assembly in the support stent such that the inlet of the valve assembly is spaced radially inwardly of the support stent and forms an annular space between an inner surface of the support stent and the valve assembly at the inlet of the valve assembly when the support stent is in the expanded configuration. The annular space can have a width in a radial direction between 0.5 cm and 3 cm.

Abstract: An artificial heart valve stent including: a tubular stent body having an inflow side end and an outflow side end, the inflow side end and the outflow side end being opposite to each other; an inflow side skirt surrounding the external wall of the stent body; and an outflow side skirt surrounding the external wall of the stent body. In a spread state, free ends of the inflow side skirt and the outflow side skirt extend toward the inflow side end; and the inflow side skirt cooperates with the outflow side skirt to clamp heart valve tissues. The artificial heart valve stent can be steadily arranged on heart valve tissues, prolong the service life of an artificial heart valve and reduce the risk of another artificial heart valve replacement for the patient.

Abstract: A linking member extends from a first linking site of a longitudinal member to a second linking site of the longitudinal member. An anchor driver is configured to anchor portions of the longitudinal member to tissue using tissue anchors. A distal portion is anchorable to a first tissue location while the first linking site is within a catheter. While the distal portion is anchored to the first location, and the second linking site is within the catheter, a second portion is advanceable distally out of the catheter and is anchorable to a second tissue location. While the second portion is anchored to the second location, the second linking site and a third portion are advanceable distally out of the catheter. After the second linking site has been advanced out of the catheter, the third portion is anchorable to a third tissue location. Other embodiments are also described.

Abstract: An implantable prosthetic device includes a coaption portion, paddles, and clasps. The paddles are extendable from a folded closed position to an open position. A clasp is attached to each of the paddles. The clasps have a fixed arm attached to the paddle and a moveable arm. The moveable arm has a barbed portion, a first eyelet, and a second eyelet. The hinge portion connects the fixed arm to the moveable arm. A first intermediate suture loop is attached to the first eyelet and a second intermediate suture loop is attached to the second eyelet. At least one actuation suture is attached to the first and second intermediate suture loops.

Abstract: Described embodiments include apparatus (20) that includes an assembly of tubes (34), each one of the tubes being shaped to define a tube lumen (62). The apparatus further includes a plurality of tissue anchors (60), each one of the tissue anchors being disposed within a respective one of the tube lumens, an expandable annular structure (36), including a plurality of teeth (40), coupled to the assembly of tubes, and a plurality of control wires (38) coupled to the annular structure, configured to position the tubes for deployment of the tissue anchors from the tube lumens, by manipulating the annular structure. Other embodiments are also described.

Abstract: Systems and methods for medical interventional procedures, including approaches to valve implant. In one aspect, the methods and systems involve a modular approach to treatment.

Abstract: Devices and methods are disclosed for the treatment or repair of regurgitant cardiac valves, such as a mitral valve. An illustrative annuloplasty device can be placed in the coronary sinus to reshape the mitral valve and reduce mitral valve regurgitation. The disclosure also provides improved techniques for cardiac pacing.

Abstract: A holder for a prosthetic heart valve may include a hub having an outer surface extending about a longitudinal axis, a commissure support extending downward from the hub, and a plurality of legs extending outward from the hub in radial directions, each leg having a foot extending in a longitudinal direction. Each foot may have two channels on its outer surface, each channel extending from a closed end at a spaced distance from the bottom of the foot to an open end at the bottom of the foot, and two suture holes each spaced apart from the bottom of the foot and extending between the inner surface and the outer surface of the foot.

Abstract: A device for cardiac surgery is disclosed, having a) a plurality of pairs of suture guides spaced about the frame; b) a plurality of suture tubes, with one suture tube corresponding to each pair of suture guides; c) a plurality of snares, each corresponding to and passed through one of the plurality of suture tubes so that a handle at one end of the snare protrudes from a proximal end of the corresponding suture tube and a snare loop at another end of the snare protrudes through a distal end of the corresponding suture tube, and wherein the snare loop further protrudes through one of the suture guides in the corresponding pair of suture guides; and d) a plurality of sutures, each corresponding to one of the pairs of suture guides and coupled to the suture guide in the corresponding pair of suture guides which does not have the snare loop passing through it.

Abstract: A stentless support structure capable of being at least partly assembled in situ. The support structure comprises a braided tube that is very flexible and, when elongated, becomes very long and very small in diameter, thereby being capable of placement within a small diameter catheter. The support structure is preferably constructed of one or more thin strands of a super-elastic or shape memory material such as Nitinol. When released from the catheter, the support structure folds itself into a longitudinally compact configuration. The support structure thus gains significant strength as the number of folds increase. This radial strength obviates the need for a support stent. The support structure may include attachment points for a prosthetic valve.

Abstract: A system for treating valvular regurgitation in a heart valve includes a flexible canopy and an elongated tether including an elastic portion and an inelastic portion. When the system is in a deployed configuration, a proximal end of the flexible canopy is coupled to an annulus of the heart valve and a distal end of the elongated tether is coupled to a ventricle. The flexible canopy is configured to overlay a first native leaflet of the heart valve, and tension on the elongated tether is applied and/or adjusted to prevent the first leaflet from prolapsing, to maximize coaptation of the flexible canopy with a second native leaflet of the heart valve, and to minimize regurgitation of the heart valve.

Abstract: Disclosed is a medical system for short time replacement and repair of a native valve, which comprises an artificial valve (502); and a device for collecting and arranging chordae and/or leaflets to hold and/or stabilize the artificial valve in a desired position, the device comprising: a unit for grasping a plurality of chordae and/or leaflets. The system and/or device allows for fast and easy replacement of a native valve, fast and easy positioning of a temporary artificial valve, and more time for medical personnel to make decisions, prepare and/or perform surgery/medical intervention.

Abstract: A method of placing an implant including a stent at a native heart valve site includes orienting an expandable body of the stent such that a first open end of the stent is upstream a second open end of the stent relative to a direction of blood flow through a native heart valve. The native heart valve includes native leaflets and an annulus. The method also includes radially expanding a plurality of positioning arches positioned around an outer perimeter of the expandable body. The method additionally includes inserting the plurality of positioning arches respectively within a plurality of pockets defined by leaflets of the native heart valve and a heart structure from which the native leaflets extend. The method further includes radially expanding the first open end of the stent into a position upstream of the annulus and out of contact with nerve bundles.

Abstract: An embodiment includes a chordal replacement system comprising: a pledget coupled to a first suture length and at least one of a first needle and a first ferrule; a second suture length coupled to the pledget and at least a second needle; and a third suture length coupled to the pledget and at least a third needle; wherein the second and third suture lengths are not monolithic with each other and do not constitute a single suture. Other embodiments are described herein.

Abstract: A prosthetic heart valve (1) for implantation at the mitral annulus of a heart, the prosthetic heart valve comprising: a support framework (10) reversibly transformable between a collapsed configuration and an expanded configuration; and one or more leaflets connected to the framework; wherein, in the expanded configuration: the support framework defines a fluid pathway through the prosthetic heart valve, the fluid pathway having a portion with a D-shaped cross section for engaging the mitral annulus; and the one or more leaflets allow fluid to pass through the fluid pathway in a first direction but prevent fluid from flowing in the opposite direction.

Abstract: This invention discloses a valved stent for implantation at a dysfunctional or diseased atrioventricular valvular annulus. The valved stent is expandable from a collapsed shape to an expanded shape for minimally invasive delivery and has a low profile at the atrial or superior aspect to achieve improved hemodynamics and offers the capability to fabricate replacement valves having large diameters, The invention also includes a delivery apparatus uniquely designed for implantation of the valved stent and offering the potential for controlled and precise placement of the valved stent at the atrioventricular annulus. The invention also includes methods for use of the above devices and for treating diseased atrioventricular valves.

Abstract: Devices, systems, and methods for crimping a medical device are disclosed. More specifically, the present disclosure relates to devices, systems, and methods for reducing the diameter of a collapsible heart valve prosthesis to be loaded onto a delivery device. The devices, systems, and methods using at least one funnel to crimp the heart valve prosthesis and load it onto the delivery system.

Abstract: A system for implanting a repair device onto a native valve of a natural heart to repair the native valve of a patient during a non-open-heart procedure. The system includes a base assembly, a pair of paddles, and a pair of gripping members. The base assembly includes a shaft and a coupler attached to the shaft such that the coupler can be moved along the shaft. The paddles are movable between an open position, a closed position and a bailout position. The paddles and the gripping members are configured to attach to the native valve of the patient. Movement of the coupler along the shaft causes the paddles to move between the open position, the closed position, and the bailout position. When the paddles are in the bailout position, a bailout angle between each paddle of the pair of paddles and the shaft is greater than or equal to 120 degrees.

Abstract: A method of implanting a prosthetic mitral valve includes advancing a delivery apparatus into a left side of a patient's heart and deploying a support structure from the delivery apparatus. The support structure extends around native mitral valve leaflets such that the native leaflets are disposed radially within the support structure. The method also includes advancing a prosthetic heart valve within the native leaflets. The prosthetic heart valve is separate from the support structure and includes an annular frame and a valve structure positioned within the annular frame, and prosthetic heart valve is in a radially collapsed configuration. The method further includes expanding the prosthetic heart valve from the radially collapsed configuration to a radially expanded configuration. In the radially expanded configuration, the annular frame of the prosthetic heart valve engages the native leaflets and is separated from the support structure by the native leaflets.

Abstract: Embodiments include prosthetic valves and related methods. In an embodiment, an implantable valve is included having a frame that includes a plurality of frame struts. The frame can define a central lumen. An outer skirt can be disposed on an abluminal surface of the frame. The outer skirt can include a flap having a first end and a second end. The first end of the flap can be fixed to the abluminal surface of the frame and the second end can be free to move away from the abluminal surface of the frame. Other embodiments are also included herein.

Abstract: An instrument for repairing an atrioventricular heart valve, the instrument including a tubular element having an outer, distal end; a distal implant part arranged in the tubular element; an artificial chord arranged in the tubular element; a proximal implant part arranged in the tubular element; and, an anchor carrier arranged in the tubular element. The distal implant part and the proximal implant part are arranged in the tubular element beside one another, with the distal implant part being closer to the distal end of the tubular element than the proximal implant part The proximal implant part is assembled with the anchor carrier inside the tubular element so that the tubular element prevents the proximal implant part from escaping from the anchor carrier as long as the anchor carrier is within the tubular element.

Abstract: A heart valve therapeutic device (1) comprises a coaptation assist valve (20) comprising a conduit (2) with an outer surface (3) for coaption with the native leaflets, and a prosthetic flow valve (5) mounted within the conduit (2) to allow one-way flow through the conduit (2). Support for the coaptation assist valve (20) is provided by a support (10) for positioning the conduit (2) across the native leaflets, and connectors (15) attaching the conduit (2) to the support (10).

Abstract: An apparatus for replacing a diseased cardiac valve is movable from a radially collapsed configuration to a radially expanded configuration. The apparatus comprises an expandable support member and a prosthetic valve secured therein. The main body portion extends between first and second end portions and includes an outer circumferential surface, a circumferential axis extending about the circumferential surface, and a plurality of wing members spaced apart from one another by an expandable region. Each of the wing members includes first and second end portions and a flexible middle portion extending between the end portions. The second end portion is integrally formed with the uyimain body portion. The first end portion is adjacent the circumferential axis and substantially flush with the outer circumferential surface in the radially collapsed configuration. The first end portion extends substantially radial to the outer circumferential surface in the radially expanded configuration.

Abstract: An assembly for transvascular replacement of a native aortic heart valve can have a radially collapsible and self-expandable prosthetic heart valve and a delivery apparatus. The valve can have an annular metal frame made of a shape-memory material with a plurality of posts extending from an end portion of the frame. The delivery apparatus can have a shaft comprising a valve connection portion that is releasably coupled to the posts of the valve. The valve connection portion can have a plurality of discrete radially facing recesses that receive the posts. The delivery apparatus can have a delivery sheath that is positioned around the prosthetic heart valve and the valve connection portion of the shaft to maintain the prosthetic heart valve in a radially compressed state and maintain the posts within the recesses. The delivery apparatus can cause relative axial motion between the delivery sheath and the valve.

Abstract: Methods of transcatheter delivery of a prosthetic heart valve. A distal region of a guide member assembly is advanced into a heart of a patient. The distal region is docked to native anatomy of the heart. A delivery device, including a collapsed prosthetic heart valve, is advanced over the docked guide member assembly. The collapsed prosthetic heart valve is located at an implantation site. The prosthetic heart valve is deployed from the delivery device, and then the delivery device is removed from the patient. At least a portion of the guide member assembly is removed from the patient. In some embodiments, the docking structure is docked to one or more of native mitral valve leaflets, chordae in the left ventricle, or walls of the left ventricle as part of a transseptal mitral valve delivery procedure.