Abstract: A device (100) for the excision of a heart valve via a percutaneous route having a proximal (20) and distal (30) end, comprising an expandable cutting instrument, ECI, that forms a receptacle in the open configuration for receiving, compacting and containing the excised heart valve, an expandable cutting block, ECB, and a displacement mechanism (5, 6) for adjusting the distance between the ECI and the ECB (70).

Abstract: A delivery catheter for a prosthetic heart valve, the valve expandable from a collapsed condition for delivery to an ex paneled condition for implantation, the delivery catheter comprising: a holder for engaging the valve in the collapsed state of the valve, the holder configured such that (i) in response to a radial compression force exerted thereon, the holder has a first shape defining an exposed engagement region for engaging at least a portion of the collapsed prosthetic heart valve for restraining axial displacement of the prosthetic valve in at least one axial direction of the catheter, and (ii) in response to removal of the radial compression force upon expansion of the valve, at least a portion of the holder transitions to a second shape.

Abstract: Described embodiments are directed toward centrally-opening, leaflet valve devices and systems for transcatheter delivery having a two-piece valve body as well as methods of making and delivering the two-piece valve devices. A transcatheter valve includes a collapsed configuration and an expanded configuration. The transcatheter valve can further include an everted configuration and a non-everted configuration.

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: A method of inserting a stent includes inserting a unitary, monolithic catheter assembly into a cardiac artery. The catheter assembly includes a body having a proximal end and a distal end, a distal balloon mounted on the distal end, and a proximal balloon mounted on the body, proximally of the distal balloon. A balloon expandable stent is mounted on the distal balloon. The method further includes the steps of advancing the catheter assembly to a blockage in the artery until the distal balloon and the stent both extend across the blockage; inflating the distal balloon and expanding the stent; deflating the distal balloon; advancing the catheter body distally until the proximal balloon extends within the stent; expanding the proximal balloon to post-dilate the stent; deflating the proximal balloon; and withdrawing the catheter body from the artery.

Abstract: Heart valve prosthesis recapture devices and methods for recapture are disclosed, which can be used for recapturing a partially deployed heart valve prosthesis. The recapture device comprises a recapture sleeve, configured to envelop and collapse a partially deployed heart valve prosthesis. The recapture sleeve comprises a distal end, configured to be securely attached to a guide wire, and a proximal end, comprising an opening along a longitudinal axis of the recapture sleeve. The opening can be configured to expand as it engages the heart valve prosthesis, and be biased toward a closed configuration. An attachment element can interface with the distal end of the recapture sleeve and be securely attached to a guide wire, such as by crimping. The recapture sleeve can include a support structure comprising at least one spine and a plurality of ribs.

Abstract: Embodiments of the present disclosure include a method of transcatheterly delivering a band to encircle multiple papillary muscles in a heart. The method may comprise transcutaneously inserting a catheter into a heart and delivering a first end of a first guidewire to a ventricle in the heart via the catheter. The method may further comprise looping a first end of a first guidewire around a first papillary muscle and a second end of a second guidewire around a second papillary muscle. The first end of the first guidewire and the second end of the second guidewire may be brought out of the body while the first and second guidewires remain looped around the first and second papillary muscles, respectively. The first and second guidewires may be interconnected, and at least one end of the first and second guidewires may be pulled to establish a single loop around the papillary muscles.

Abstract: A prosthetic implant delivery assembly can include a prosthetic implant and an elongate catheter. The prosthetic implant can include an expandable stent portion having a longitudinal axis extending from a first end portion of the stent to a second end portion of the stent. The catheter can include a longitudinal axis extending from a proximal end portion of the catheter to a distal end portion of the catheter and a plurality of arms extending axially from the distal end of the catheter. The first end portion of the stent can be releasably and pivotably coupled to at least one the arms of the catheter such that the stent can pivot about the at least one of the arms so that the longitudinal axis of the stent is tilted relative to the longitudinal axis of the catheter.

Abstract: A delivery device for a stented heart valve comprises a handle, an inner catheter shaft extending from the handle and having an enlarged bumper element at a distal end, an outer catheter shaft extending from the handle and slidably coupled around the inner catheter shaft, and a retraction mechanism for controlling longitudinal movement of the outer catheter shaft relative to the inner catheter shaft. The outer catheter shaft includes a generally cylindrical housing at a distal end that is structured to receive the bumper element therein.

Abstract: A delivery system and method for delivery of an annuloplasty implant for a patient are disclosed. The delivery system comprises a commissure locator device for locating a commissure, comprising; an extension member, a catheter, and wherein the extension member is extendable relative the catheter for location of at least one commissure of a cardiac valve, and a coronary sinus contractor for temporary insertion into the coronary sinus (CS) and having a displacement unit being temporarily transferable to an activated state in which the shape of the annulus of the heart valve is modified to a modified shape to be retained by said annuloplasty implant.

Abstract: A method is provided for repairing the tricuspid valve of a patient using tension. A radially-expandable stent is implanted in a coronary sinus of the patient. A tissue anchor is implanted in tissue in the vicinity of the tricuspid valve. The tricuspid valve is repaired by applying tension between the radially-expandable stent and the tissue anchor using a flexible longitudinal member that connects the radially-expandable stent and the tissue anchor.

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 pair of paddles and a pair of gripping members. The paddles are movable between an open position and a closed position. The paddles and the gripping members are configured to attach to the native valve of the patient. The paddles are biased to the closed position, latched to the gripping members in the closed position, maintained in the closed position by a threaded connection, or otherwise maintained in the closed position.

Abstract: A stented valve including a stent structure having a generally tubular body portion, an interior area, a longitudinal axis, an first end, an second end, and an outer surface; at least one outflow barb extending from the outer surface of the stent adjacent to the first end of the stent structure and toward the second end of the stent structure; at least one inflow barb extending from the outer surface of the stent adjacent to the second end of the stent structure and toward the first end of the stent structure; and a valve structure attached within the interior area of the stent structure.

Abstract: A low profile transseptal catheter and implant system is disclosed. Access to the mitral valve can be obtained using femoral catheterization with a fluoroscopically guided, low-profile catheter. For example, the right atrium is accessed and the interatrial septum punctured to access the left atrium, and the mitral valve is approached through the left atrium. Advantageously, this approach avoids contact with the left ventricular outflow tract and the chordae tendinae. Two leaflet braces are extended over guide wires to form semicircular loops that circumnavigate the anterior and posterior mitral valve leaflets. Tension is applied to the catheter from the atrial direction to keep the leaflet braces tightly wedged under the leaflets for the remainder of the procedure. A fastener joins the ends of each loop to create one annular ring encircling the valve under the anterior and posterior leaflets.

Abstract: Systems and methods for replacing a heart valve. An expansible helical anchor is formed as multiple coils to support a valve prosthesis. At least one of the coils is expandable to a second, larger diameter upon application force from within the anchor. A gap is defined between adjacent coils sufficient to prevent engagement by at least one of the adjacent coils with the native heart valve. An expansible heart valve prosthesis is provided and is configured to be delivered into the anchor and expanded inside the coils into engagement. This moves the coil from the first diameter to the second diameter while securing the anchor and prosthesis together. The system further includes a seal on the expansible heart valve prosthesis configured to engage the helical anchor and prevent blood leakage past the heart valve prosthesis after implantation of the heart valve prosthesis in the helical anchor.

Abstract: Embodiments of the present disclosure are directed to stents, valved-stents, (e.g., single-stent-valves and double stent/valved-stent systems) and associated methods and systems for their delivery via minimally-invasive surgery. The stent component comprises a first stent section (102) a second stent section (104) a third stent section (106) and a fourth stent section (108).

Abstract: An actuating member, which makes a flexible elongated member for medical use perform a predetermined action, includes a push/pull member and an operating member. The push/pull member includes a first moving portion and a second moving portion which are disposed on a proximal side and are movable relative to each other, a first extending portion that extends from the first moving portion, and a second extending portion that extends from the second moving portion. The push/pull member is pushed/pulled in conjunction with a movement of the first moving portion and the second moving portion. The operating member is rotatable in a circumferential direction of the elongated member. The operating member includes a first guide portion and a second guide portion, which guide the first moving portion and the second moving portion. The push/pull member is capable of making the elongated member perform an advance/retraction action and/or a bending action.

Abstract: A prosthetic apparatus for implantation at a native valve complex includes a main body configured for placement within the native valve, at least one downstream arm and at least one upstream arm, each coupled to and disposed outside of the main body. The main body includes a compressed state for delivery and an expanded state. In the expanded state, a space exists between the downstream arm and an outer surface of the main body to receive an edge of a native valve leaflet. A portion of the downstream arm is configured to extend behind the received native leaflet and engage a downstream surface of the native valve complex while the edge of the received native leaflet is not engaged by the downstream arm. The upstream arm is configured to engage an upstream surface of the native valve complex at a location opposite the portion of the downstream arm.

Abstract: A prosthetic valve comprising a conical shaped sheet member comprising an extracellular matrix (ECM) composition and an internal multi-link support stent structure, the sheet member having a plurality of open slit regions that are disposed uniformly on linear planes that are parallel to the sheet member longitudinal axis, and a proximal annulus engagement end diameter and length ratio in the range of 5:1 to 2:1.

Abstract: A prosthetic valve comprising a conical shaped sheet member comprising an extracellular matrix (ECM) composition, the sheet member having a plurality of open slit regions that are disposed uniformly on linear planes that are parallel to the sheet member longitudinal axis, and a proximal annulus engagement end diameter and length ratio in the range of 5:1 to 2:1.

Abstract: The present invention relates to an apparatus (100) for folding or unfolding at least one medical implant (300) by using at least one tension thread (11, 11?), wherein the apparatus (100) includes a shaft (1) including a reception area (55) for receiving the implant (300), and a tensioning device for altering a shape of the foldable and/or unfoldable implant (300) by the tension thread (11, 11?).

Abstract: A heart valve sizing ring is disclosed. The sizing ring includes an outer ring and an inner ring configured and arranged to couple to the outer ring. A tubular portion extends from the inner ring and has a plurality of suture holders arranged about an upper end thereof. The outer ring and inner ring having a pair of complementary mating surfaces configured and arranged to grip sutures therebetween when coupled together. When coupled around sutures, the assembled ring may be tightened down against the heart valve to test the fit as if the sizing ring were a similarly sized prosthetic heart valve ring. Commissures of the heart valve may be suspended from the suture holders of the tubular portion. The surgeon can then remove the sizing ring and replace it with a prosthetic ring.

Abstract: A heart valve prosthesis configured to be implanted at cardiac valve annulus located at an interface between a ventricle (LV) and an atrium (LA), the heart valve prosthesis including: a first portion configured for enclosing a plurality of chordae tendineae (CT) in the ventricle (LV) and native valve leaflets (NVL) to which said chordae tendineae are connected, and a second portion including a radially expandable annular member and a prosthetic heart valve anchored to said radially expandable annular member, wherein said first portion is configured to be implanted in the ventricle (LV), and wherein said second portion is configured to be implanted and coupled to the first portion at the cardiac valve annulus.

Abstract: Disclosed are systems and methods relating to an implant configured for reshaping a mitral valve. The implant comprises a plurality of struts with anchors for tissue engagement. The implant is compressible to a first, reduced diameter for transluminal or transapical navigation and delivery to the left atrium of a heart. The implant may then expand to a second, enlarged diameter to embed its anchors to the tissue surrounding and/or including the mitral valve. The size and/or shape of the implant may then be adjusted, pulling mitral annulus tissue radially inwardly, and restrained in the adjusted configuration to improve mitral valve function.

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 system for treating mitral valve regurgitation includes a tensioning device having a plurality of helical anchors and a tensioning filament. One embodiment of the invention includes a method for attaching a tensioning device to the annulus of a mitral valve in a trans-leaflet configuration, and applying a tension force to the tension filament in order to exert force vectors on the annulus, thereby reshaping the mitral valve annulus so that the coaption of the anterior and posterior leaflets of the mitral is improved during ventricular contraction.

Abstract: A stent includes a tubular support structure extending from a distal end to a proximal end, the tubular support structure including an inner surface and an outer surface. A retractable anchor system is disposed relative to the tubular support structure and includes a frame member and a plurality of retractable anchors secured to the frame member. The plurality of retractable anchors are biased to a deployed configuration in which the plurality of retractable anchors extend radially outward from the outer surface of the tubular support structure but are radially inwardly compressible into a delivery configuration.

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: A system for implanting a repair device onto a native valve of a natural heart to repairing the native valve of a patient during a non-open-heart procedure. The system includes a pair of paddles and a pair of gripping members. The paddles are moveable between an open position and a closed position. The gripping members can have different configurations for effective attachment and release from the native valve of the patient.

Abstract: A prosthetic heart valve (300) for replacing a native heart valve includes a collapsible and expandable stent (306) extending in a length direction between a proximal end (302) and a distal end (304), the stent (306) including a plurality of struts (320) defining a plurality of cells (330), the plurality of cells (330) forming an aortic section (310), an annulus section (314) and a subannular section (316) of the stent (306). A valve assembly is disposed within the annulus section (314) of the stent (306), the valve assembly including a plurality of leaflets. In an expanded condition of the stent, each of the plurality of cells of the subannular section (316) has a width greater than its length, and each of the plurality of cells of the annulus section (314) has a length greater than its width.

Abstract: A system for implanting a repair device onto a native valve of a natural heart to repairing the native valve of a patient during a non-open-heart procedure. The system includes a pair of paddles and a pair of gripping members. The paddles are movable between an open position and a closed position. Each of the gripping members has a barbed portion for securing the gripping members to the native valve of a patient. Each gripping member is slidably attached to a corresponding paddle. Each gripping member can be moved in a first direction along the paddle before the barbed portion of the gripping member pierces the native valve of the patient. Each gripping member can be moved in a direction substantially opposite the first direction after the barbed portion pierces the native valve of the patient such that the gripping members create a tensioning force on the native valve of the patient.

Abstract: Devices and methods for the repair of the functioning of heart valves are provided. A device may comprise a ventricular winding having a generally spiral shape, wherein the device is free of any atrial stabilizing section. A method involves positioning the device such that chords associated with the heart valve are positioned within the path of the generally spiral shape of the ventricular winding and turning the ventricular winding such that the chords move closer to the center of the ventricular winding. The ventricular winding draws the chords closer together, thereby pulling the valve leaflets closer together in order to facilitate their coaptation and proper closing. A delivery system for maneuvering and releasing a heart valve repair device comprises an applicator tube and internal rod.

Abstract: A system for implanting a heart valve includes a radially self-expandable tubular body having an inflow end and an outflow end and a preformed groove disposed at an outer surface of the tubular body between the inflow end and the outflow end. The preformed groove extends at least partially around the tubular body and has a circumferential opening facing radially outward of the tubular body. A valve is disposed within and is attached to the tubular body, and an elongate outer member is configured to form a loop encircling the preformed groove so as to guide portions of native valve leaflets and/or chords into the preformed groove. The outflow end of the tubular body includes a frustoconical shape that slopes radially outward from the preformed groove toward the outflow end when the outflow end but not the inflow end has been released from a delivery catheter.

Abstract: An endoprosthesis is conditioned prior to use within a patient by placing a scaffold of the endoprosthesis in contact with a sterile liquid optionally at body temperature, following by causing the scaffold to bend. The scaffold may be bent by moving the scaffold through a conditioning tube.

Abstract: The present disclosure is directed to embodiments of catheter-based prosthetic heart valves, and in particular, prosthetic heart valves having sealing devices configured to seal the interface between the prosthetic valve and the surrounding tissue of the native annulus in which the prosthetic valve is implanted. In one embodiment, a prosthetic heart valve includes an annular sealing member that can be placed in a delivery orientation extending axially away from one end of the valve when the valve is in a radially compressed state. When the valve is expanded, the expansion of the frame causes the sealing member to be pulled to an operative orientation covering a portion of the frame. The present disclosure also discloses new mechanisms and techniques for mounting valve leaflets to a frame of a prosthetic heart valve.

Abstract: A stent for use in a prosthetic heart valve has a plurality of expandable and collapsible closed cells, a portion of which form an annulus section adapted for placement within the annulus of the native heart valve. Anchor features of the stent residing within at least some closed cells are adapted to engage tissue of the heart, including native valve leaflets, the sinotubular junction, or another implanted device when the prosthetic valve is implanted in the heart. The anchor features may help to retain the prosthetic valve in position, without interfering with the opening and closing of the valve leaflets. Furthermore, the anchor features may be configured to allow the stent to be resheathed into a delivery device after the portion of the stent with the anchor feature has expanded out of the delivery device.

Abstract: A device for placing a seal around an implant in a blood vessel, and associated treatment kit are provided. This device (24) includes a hollow sheath (60) having a longitudinal axis (Y-Y?), and at least one release member (62), which may be deployed with respect to the sheath (60) between a retracted position in the sheath (60) and an extracted position out of the sheath (60). The device (24) includes, for said or each release member (62), a seal body (64) having an angular extent strictly less than 360° around the longitudinal axis (Y-Y?), the seal body (64) being releasably attached onto the release member (62) so as to be released from the release member (62).

Abstract: A quick-connect heart valve prosthesis that can be quickly and easily implanted during a surgical procedure is provided. The heart valve includes a substantially non-expandable, non-compressible prosthetic valve and a plastically-expandable frame, thereby enabling attachment to the annulus without sutures. A small number of guide sutures may be provided for aortic valve orientation. The prosthetic valve may be a commercially available valve with a sewing ring with the frame attached thereto. The frame may expand from a conical deployment shape to a conical expanded shape, and may include web-like struts connected between axially-extending posts. A system and method for deployment includes an integrated handle shaft and balloon catheter. A valve holder is stored with the heart valve and the handle shaft easily attaches thereto to improve valve preparation steps.

Abstract: Systems and methods for docking a heart valve prosthesis. A system includes a helical anchor (30) formed as multiple coils (32) adapted to support a heart valve prosthesis (10) with coil portions (32) positioned above and below the heart valve annulus (12). A seal (50) is coupled with the helical anchor (30) and includes portions extending between adjacent coils (32) for preventing blood leakage through the helical anchor (30) and past the heart valve prosthesis (10). An expansible helical anchor (30) is formed as multiple coils (32) adapted to support a heart valve prosthesis (10). At least one of the coils (32) is normally being at a first diameter, and is expandable to a second, larger diameter upon application of radial outward force from within the helical anchor (30).

Abstract: A valve prosthesis for replacing an atrioventricular valve of the heart is disclose, having a double ring body, on which heart cusps are fastened and that comprises a ventricle-side ring and an atrium-side ring, wherein the ventricle-side ring has an oval shape, and wherein anchors projecting substantially radially outward are arranged on the ventricle-side ring.

Abstract: A delivery system for an implantable medical device having at least one retention member at an end thereof includes a shaft extending in a longitudinal direction. An elongated sheath surrounds the shaft. The sheath is slidable relative to the shaft in the longitudinal direction. A space is defined inside of the sheath and is adapted to receive the medical device in an assembled or collapsed condition. A retainer is positioned at a first end of the space. At least one recess is provided in the retainer and is adapted to receive the retention member of the medical device in the assembled condition. A selectively activable member is disposed in the compartment between the longitudinal shaft and the medical device. When in an activated state, the member expands radially relative to the shaft, thereby urging the retention member to disengage from the recess.

Abstract: Methods and apparatus for holding and maneuvering a valve during preparation and attachment to patient, providing increased visibility of the prosthetic valve and the sewing ring to prevent suture entanglement. A handle attachment is spaced from the valve for improved visibility of the sewing ring and the outlet end of the valve during attachment. Commissure posts are bent inward at the tips while preventing crashing of the commissure posts into each other causing damage. A release force needed to remove the holder and unthread the holder sutures is reduced. The holder and related methods can provide a kink free holder suture path to reduce suture entanglement and prevent damage to the implanted valve during holder removal by reducing the release force needed to remove the holder sutures by up to 30%.

Abstract: Embodiments of a prosthetic heart valve comprise an annular main body, an atrial cap extending radially outwardly from the atrial end of the main body, and a plurality of ventricular anchors extending outwardly from the ventricular end of the main body. Each ventricular anchor can have a proximal end portion connected to the ventricular end, an intermediate portion extending away from the atrial end and then back toward the atrial so as to define a first bend, and a free distal end portion that extends from the intermediate portion. The distal end portion can comprise a first section, a second section, and a second bend between the first and second sections, the first section extending from the intermediate portion in a direction toward the atrial end and radially away from the main body.

Abstract: In one representative embodiment, a prosthetic valve assembly comprises a valve component comprising a radially compressible and expandable frame and a valve structure supported inside of the frame. The valve structure is configured to allow blood to flow through the valve component in one direction and block the flow of blood in the opposite direction. The assembly further comprises a radially compressible and expandable anchor comprising an annular base and a plurality of cantilevered fixation members extending from the base. The fixation members are configured to pivot inwardly toward the valve component when the valve component is radially expanded within the anchor.

Abstract: A device for supporting soft tissue includes a tubular body and is constituted of a sequence of compliant portions and anchoring portions. The anchoring portions each include anchor members adapted to penetrate into soft tissue. The compliant portions each include deformable members extending between ends of the compliant portion, at least one of a distance and orientation between said ends being adjustable by application of a force on the tubular body. The tubular body includes a ring-like shape reached at least by deformation of the compliant portions, the ring-like shape having the anchor members of the anchoring portions protruding circumferentially along a direction defined by a vector having a component being at least tangential to the curve of the ring-like shape, for the anchor members to penetrate the soft tissue. A method for anchoring the device to soft tissue is also provided.

Abstract: A method for stabilizing a cardiac valve annulus is provided. The method includes intravascularly delivering a prosthesis to a region of a cardiac valve, expanding the prosthesis to secure the prosthesis to the region of the cardiac valve, and reducing the inner diameter of the prosthesis to form the region of the cardiac valve into a predefined shape.

Abstract: The invention is a system and method for accurately positioning a prosthetic valve such as a prosthetic heart valve at a desired position for deployment. The invention includes extendable positioning elements which provide tactile feedback to a user to confirm proper positioning of the catheter with respect to the native valve annulus. During delivery, the extendable positioning elements lie against the catheter, over the prosthetic valve and expandable balloon, providing a low profile for advancing the catheter to the desired treatment location via small passages such as body lumens. Prior to valve deployment, the positioning elements are extended and brought into contact with tissue of the native annulus to confirm the proper positioning of the delivery system and prosthetic valve.

Abstract: A prosthetic valve system for replacing a native aortic valve exhibiting regurgitation comprises a support structure and a transcatheter heart valve (THV) that is separate from the support structure. The support structure is radially collapsible and expandable, and deployable on an outflow side of the native aortic valve, circumscribing the native leaflets of the aortic valve. The THV is radially collapsible and expandable, and deployable in an annulus of the native aortic valve to frictionally engage the native leaflets between an interior surface of the support structure and the THV.

Abstract: Disclosed prosthetic valves can comprise a sewing ring configured to secure the valve to an implantation site. Some disclosed valves comprise a resiliently collapsible frame having a neutral configuration and a collapsed deployment configuration. Some disclosed frames can self-expand to the neutral configuration when released from the collapsed deployment configuration. Collapsing a disclosed valve can provide convenient access to the sewing ring, such as for securing the valve to the implantation site, as well as for the insertion of the valve through relatively small surgical incisions. Examples of delivery systems and methods for deploying the valves exhibit reduced patient trauma.

Abstract: An improved holder and method for implanting a tissue-type prosthetic mitral heart valve that prevents suture looping and ma y also constrict the commissure posts of the valve. An upstanding or shaft member axially positioned on the holder causes the lengths of attachment sutures to extend axially beyond the commissure post tips to create a tent and prevent looping of any of an array of pre-implanted sutures around the tips during deployment of the valve. The shaft member may be axially movable such that it can be initially retracted and then actuated just prior to valve deployment. The shaft member may have notches on its distal tip for capturing the attachment sutures, which are crossed over along the valve axis to ensure engagement by the notches. The attachment sutures may be strands or filaments, or may be wider bands of flexible biocompatible material. If bands are used, they desirably cover the commissure post tips to further help prevent suture looping thereover.