Transseptal Delivery System for Aortic Valve Therapeutic Devices

Abstract

A system and method used to deliver an aortic valve therapeutic device, such as a delivery device for an aortic valve replacement, to an aortic valve site. The system includes a cable percutaneously introduced a cable into a vasculature of a patient and positioned to run from a femoral vein, through the heart via a transseptal puncture, and to a femoral artery. The therapeutic device is passed over an end of the cable at the venous side and is secured to the cable. The therapeutic device is pushed in a distal direction while the second end of the cable is pulled in the proximal direction to advance the therapeutic device to the mitral valve site. A left ventricle redirector aids in orienting the therapeutic device and preventing migration of the cable towards delicate mitral valve structures and chordae tendoneae during advancement of the therapeutic device.

We claim: 
     
         1 . A system for of delivering an aortic valve therapeutic device to an aortic valve site, comprising:
 a cable proportioned for introduction into a vasculature of a patient and for positioning in the vasculature to run from a femoral vein, through a heart via a transseptal puncture, and to a femoral artery such that the positioned cable has a first end external to the patient at the femoral vein and a second end external to the patient at the femoral artery;   an aortic valve delivery device with an aortic valve replacement device thereon, the aortic valve delivery device removably attachable to the first end of the cable and including a distal nose;   a left ventricle redirector (LVR) having a tubular lumen, the lumen at the distal end advanceable over the second end of the cable at the femoral artery and advanceable though an aorta and aortic valve to a left ventricle,   wherein the distal nose of the aortic valve delivery device is engageable with the distal end of the LVR, and wherein the distal end of the LVR is actively steerable within the heart when engaged with the aortic valve therapeutic device to actively change an orientation of the aortic valve delivery system within the heart.   
     
     
         2 . The system of  claim 1 , further including a tubular connector having a distal end and a proximal end, wherein the distal nose of the aortic valve delivery device is engageable with the proximal end of the tubular connector and the distal end of the tubular connector is engageable with the distal end of the LVR. 
     
     
         3 . The system of  claim 1 , further including a right-to-left conduit (RLC) insertable from the femoral vein into an inferior vena cava into a right atrium, through an interatrial septum into a left atrium, through a mitral valve to a left ventricle, and through an aortic valve into an aorta, wherein the second end of the cable is insertable into the RLC at the femoral vein and advanceable through the RLC and out a distal end of the RLC. 
     
     
         4 . The system of  claim 3 , further including:
 a balloon catheter having an expandable balloon, the balloon catheter introducible into in the right atrium, insertable through the interatrial septum into the left atrium, and inflatable within the left atrium such that the balloon catheter is carried by blood flow into and through the aorta to the femoral artery, wherein the RLC is introduceable over a proximal end of the balloon catheter and advanceable to position a distal end of the RLC in the left femoral artery, wherein the second end of the cable is introduceable into the RLC at the femoral vein and advanceable to the distal end of the RLC; and   a snare for capturing the second end of the cable via the femoral artery and positioning the second end external to the body.