Transseptal delivery systems having a deflecting segment and methods of use

Abstract

A delivery system for delivering a heart valve prosthesis includes a delivery catheter and a heart valve prosthesis. The delivery catheter includes an outer sheath, an inner shaft, a distal nosecone, and a deflecting segment. The inner shaft is slidably disposed within the outer sheath. A distal end of the inner shaft is coupled to a proximal end of the deflecting segment, and a distal end of the deflecting segment is coupled to the distal nosecone. The deflecting segment includes a delivery state with the deflecting segment and the distal nosecone having a combined first longitudinal length. The deflecting segment further includes a deflected state with the deflecting segment having a second longitudinal length that is less than the first longitudinal length. The heart valve prosthesis includes a radially collapsed configuration and a radially expanded configuration. The deflecting segment is shape-set to the deflected state.

What is claimed is: 
     
         1 . A delivery system for percutaneously delivering a heart valve prosthesis to a site of a native heart valve, the delivery system comprising:
 a delivery catheter including,
 an outer sheath; 
 an inner shaft slidably disposed within the outer sheath; 
 a distal nosecone at a distal portion of the delivery catheter; and 
 a deflecting segment including a proximal end coupled to the inner shaft and a distal end coupled to the distal nosecone, wherein the deflecting segment has a delivery state and a deflected state; and 
   a heart valve prosthesis having a radially collapsed configuration and a radially expanded configuration,   wherein when the deflecting segment is in the delivery state, the deflecting segment and the distal nosecone have a combined first longitudinal length along a central longitudinal axis of a distal portion of the inner shaft, and when the deflecting segment is in the deflected state, the deflecting segment has a second longitudinal length along the central longitudinal axis, wherein the combined first longitudinal length is greater than the second longitudinal length.   
     
     
         2 . The delivery system of  claim 1 , wherein in the deflected state the distal nosecone extends along the central longitudinal axis such that the second longitudinal length is a combined second longitudinal length that includes a length of the distal nosecone. 
     
     
         3 . The delivery system of  claim 1 , wherein when the deflecting segment is in the deflected state the distal nosecone is laterally displaced from the central longitudinal axis, and wherein the second longitudinal length is a combined second longitudinal length that includes a length of a portion of the distal nosecone extending distal of the distal end of the deflecting segment. 
     
     
         4 . The delivery system of  claim 1 , wherein the deflecting segment is shape-set to the deflected state. 
     
     
         5 . The delivery system of  claim 1 , wherein the deflecting segment transitions from the delivery state to the deflected state by bending or curving a portion of the deflecting segment, along with the distal nosecone, away from the central longitudinal axis of the distal portion of the inner shaft. 
     
     
         6 . The delivery system of  claim 5 , wherein when the deflecting segment is in the deflected state, the deflecting segment has a substantially U-shape. 
     
     
         7 . The delivery system of  claim 5 , wherein when the deflecting segment is in the deflected state, the deflecting segment is laterally deflected from the central longitudinal axis of the distal portion of the inner shaft by an angle of deflection of substantially 135°. 
     
     
         8 . The delivery system of  claim 1 , wherein the deflecting segment transitions from the delivery state to the deflected state by axially collapsing a portion of the deflecting segment, along with the distal nosecone, proximally along the central longitudinal axis of the distal portion of the inner shaft. 
     
     
         9 . The delivery system of  claim 8 , wherein when the deflecting segment is in the deflected state, the deflecting segment has a wavy form. 
     
     
         10 . The delivery system of  claim 8 , wherein when the deflecting segment is in the deflected state, the deflecting segment has a coiled form. 
     
     
         11 . The delivery system of  claim 1 , wherein the deflecting segment is straightened to the delivery state by a portion of the heart valve prosthesis when the heart valve prosthesis is in the radially collapsed configuration and disposed thereabout. 
     
     
         12 . The delivery system of  claim 11 , wherein the deflecting segment is straightened to the delivery state by the outer sheath of the delivery catheter when the deflecting segment is received therein after deployment of the heart valve prosthesis. 
     
     
         13 . The delivery system of  claim 1 , wherein the heart valve prosthesis is a mitral heart valve prosthesis. 
     
     
         14 . A delivery catheter for percutaneously delivering a heart valve prosthesis to a site of a native heart valve, the heart valve prosthesis being radially expandable from a radially collapsed configuration to a radially expanded configuration, the delivery catheter comprising:
 an outer sheath;   an inner shaft slidably disposed within the outer sheath;   a distal nosecone at a distal portion of the delivery catheter; and   a deflecting segment including a proximal end coupled to the inner shaft and a distal end coupled to the distal nosecone, wherein the deflecting segment has a delivery state and a deflected state, and   wherein when the deflecting segment is in the delivery state, the deflecting segment and the distal nosecone have a combined first longitudinal length along a central longitudinal axis of a distal portion of the inner shaft, and when the deflecting segment is in the deflected state, the deflecting segment has a second longitudinal length along the central longitudinal axis, wherein the combined first longitudinal length is greater than the second longitudinal length.   
     
     
         15 . The delivery catheter of  claim 14 , wherein the deflecting segment is shape-set to the deflected state. 
     
     
         16 . The delivery catheter of  claim 14 , wherein the deflecting segment transitions from the delivery state to the deflected state by bending or curving a portion of the deflecting segment, along with the distal nosecone, away from the central longitudinal axis of the distal portion of the inner shaft. 
     
     
         17 . The delivery catheter of  claim 14 , wherein the deflecting segment transitions from the delivery state to the deflected state by axially collapsing a portion of the deflecting segment, along with the distal nosecone, proximally along the central longitudinal axis of the distal portion of the inner shaft. 
     
     
         18 . A method of delivering, positioning and deploying a heart valve prosthesis at a site of a native heart valve, the method comprising the steps of:
 advancing a delivery catheter with a heart valve prosthesis in a radially collapsed configuration retained therein to a native heart valve of a heart, wherein the delivery catheter includes an outer sheath and an inner shaft assembly, the inner shaft assembly including an inner shaft, a deflecting segment in a delivery state, and a distal nosecone;   positioning the delivery catheter with the heart valve prosthesis in the radially collapsed configuration at a native heart valve;   retracting the outer sheath of the delivery catheter to release a first portion of the heart valve prosthesis;   advancing the delivery catheter such that the first portion of the heart valve prosthesis engages tissue of the native heart valve;   advancing the inner shaft assembly such that the distal nosecone releases the second portion of the heart valve prosthesis and the deflecting segment transitions from the delivery state to a deflected state;   advancing the outer sheath of the delivery catheter such that the outer sheath advances through the heart valve prosthesis; and   retracting the inner shaft assembly such that the deflecting segment transitions from the deflected state to the delivery state as it is received within a distal portion of the outer sheath.   
     
     
         19 . The method of  claim 18 , wherein the native heart valve is a native mitral valve. 
     
     
         20 . The method of  claim 19 , wherein the first portion of the heart valve prosthesis is an inflow portion and the second portion of the heart valve prosthesis is an outflow portion, and wherein the step of advancing the delivery catheter such that the first portion of the heart valve prosthesis engages tissue of the native heart valve permits the inflow portion of the heart valve prosthesis to return to an expanded state within an atrial area of the native mitral valve, and wherein the step of advancing the inner shaft assembly such that the distal nosecone releases the second portion of the heart valve prosthesis permits the outflow portion of the heart valve prosthesis to return to an expanded state within an annulus of the native mitral valve.