Ventricular deployment of a transcatheter mitral valve prosthesis

Abstract

A method of delivering a prosthetic valve to a native mitral valve of patient's heart may include providing a radially expandable prosthetic mitral valve which has an upstream atrial portion, a downstream ventricular portion and an annular region therebetween. A constraint is removed from the ventricular portion thereby allowing radial expansion of a ventricular portion. A first anchoring tab on the ventricular portion is radially expanded and an annular region is radially expanded. An atrial skirt on the atrial flange is radially expanded after radial expansion of the ventricular portion.

1 . A method of delivering a prosthetic valve to a native mitral valve of a heart of a patient, the native mitral valve having a native anterior leaflet and a native posterior leaflet, the method comprising:
 inserting a prosthetic valve into the heart of the patient, the prosthetic valve comprising a ventricular portion and an atrial portion, wherein the ventricular portion comprises a ventricular skirt, an anterior anchoring tab disposed on the ventricular skirt, a posterior anchoring tab disposed on the ventricular skirt, and wherein the atrial portion comprises an atrial flange;   radially expanding at least one of the anterior anchoring tab and the posterior anchoring tab before the atrial portion; and   recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab.   
     
     
         2 . The method of  claim 1 , wherein radially expanding at least one of the anterior anchoring tab and the posterior anchoring tab comprises radially expanding both of the anterior anchoring tab and the posterior anchoring tab. 
     
     
         3 . The method of  claim 2 , wherein radially expanding at least one of the anterior anchoring tab and the posterior anchoring tab comprises sequentially deploying the anterior anchoring tab and the posterior anchoring tab. 
     
     
         4 . The method of  claim 1 , wherein the at least one of the anterior anchoring tab and the posterior anchoring tab is deployed before the ventricular skirt. 
     
     
         5 . The method of  claim 1 , further comprising:
 repositioning the prosthetic valve; and   redeploying the least one of the anterior anchoring tab and tab posterior anchoring tab.   
     
     
         6 . The method of  claim 1 , wherein recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab comprises untangling the at least one of the anterior anchoring tab and the posterior anchoring tab from chordae. 
     
     
         7 . The method of  claim 1 , wherein recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab comprises repositioning the at least one of the anterior anchoring tab and the posterior anchoring tab from an inside of an annulus of the native mitral valve to behind the native valve leaflet. 
     
     
         8 . The method of  claim 1 , wherein recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab comprises rotationally orienting the prosthetic valve. 
     
     
         9 . The method of  claim 5 , further comprising radially expanding the atrial portion after the ventricular portion. 
     
     
         10 . The method of  claim 1 , wherein inserting the prosthetic valve into the heart of the patient comprises: inserting the prosthetic valve trans-septally. 
     
     
         11 . The method of  claim 1 , wherein inserting the prosthetic valve into the heart of the patient comprises: inserting the prosthetic valve trans-femorally. 
     
     
         12 . The method of  claim 1 , wherein radially expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion comprises: self-expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion. 
     
     
         13 . The method of  claim 1 , wherein radially expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion comprises: balloon-expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion. 
     
     
         14 . The method of  claim 1 , wherein inserting the prosthetic valve into the heart of the patient comprises: attaching the prosthetic valve to a delivery catheter. 
     
     
         15 . The method of  claim 14 , wherein radially expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion comprises: retracting a sheath disposed around the prosthetic valve. 
     
     
         16 . The method of  claim 15 , wherein recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab comprises advancing the sheath. 
     
     
         17 . The method of  claim 15 , wherein deploying the atrial portion comprises further retracting proximally the sheath to un-constrain the atrial portion of the prosthetic valve. 
     
     
         18 . The method of  claim 14 , wherein radially expanding the at least one of the anterior anchoring tab and tab posterior anchoring tab before the atrial portion comprises: advancing a distal capsule surrounding the ventricular portion of the prosthetic valve. 
     
     
         19 . The method of  claim 18 , wherein recapturing the at least one of the anterior anchoring tab and the posterior anchoring tab comprises retracting the distal capsule. 
     
     
         20 . The method of  claim 18 , wherein deploying the atrial portion comprises retracting proximally a proximal capsule to un-constrain the atrial portion of the prosthetic valve.