Methods for delivery of prosthetic mitral valves

A method, comprising:

• inverting an outer frame of a prosthetic mitral valve relative to an inner frame of the prosthetic mitral valve when the prosthetic mitral valve is in a biased expanded configuration, wherein leaflets are attached to the inner frame, the prosthetic mitral valve being formed with a shape-memory material, an open end of the outer frame being disposed distally of an open end of the inner frame when inverted;
• after the inverting, inserting the prosthetic mitral valve into a lumen of a delivery sheath such that the prosthetic mitral valve is moved to a collapsed configuration, while remaining inverted;
• inserting the delivery sheath through a puncture site in a jugular vein of a patient, through the superior vena cava of the patient, and through the atrial septum wall of a heart of the patient and into a left atrium of the heart;
• moving the prosthetic mitral valve distally out of the lumen of the delivery sheath such that the inverted outer frame of the prosthetic mitral valve reverts and the prosthetic mitral valve assumes its biased expanded configuration, the open end of the outer frame being disposed proximally of the open end of the inner frame when reverted and the prosthetic mitral valve is in the biased expanded configuration;
• and
• positioning the prosthetic mitral valve within a mitral annulus of the heart.

A method, comprising:

• inverting an outer frame of a prosthetic mitral valve when the prosthetic mitral valve is in a biased expanded configuration, the prosthetic mitral valve being formed with a shape-memory material;
• after the inverting, inserting the prosthetic mitral valve into a lumen of a delivery sheath such that the prosthetic mitral valve is moved to a collapsed configuration, while remaining inverted;
• inserting the delivery sheath through a trans-atrial entry site directly into a left atrium of a heart of a patient;
• inserting a catheter through an opening in an apex of the heart and positioning a distal end portion of the catheter in a left ventricle of the heart;
• inserting a snare device through the catheter and into the left ventricle;
• capturing a distal portion of a tether coupled to the prosthetic valve with the snare device and pulling the portion of the tether through the catheter and outside of the heart;
• after the capturing, moving the prosthetic mitral valve distally out of the lumen of the delivery sheath such that the inverted outer frame of the prosthetic mitral valve reverts and the prosthetic mitral valve assumes its biased expanded configuration;
• and
• positioning the prosthetic mitral valve within a mitral annulus of the heart.

A method, comprising:

• inverting an outer frame of a prosthetic mitral valve when the prosthetic mitral valve is in a biased expanded configuration, the prosthetic mitral valve being formed with a shape-memory material;
• after the inverting, inserting the prosthetic mitral valve into a lumen of a delivery sheath such that the prosthetic mitral valve is moved to a collapsed configuration, while remaining inverted;
• disposing a dilator and guidewire within a lumen of the delivery sheath such that a portion of the dilator and a portion of the guidewire extend distally from the delivery sheath;
• after the disposing, inserting the delivery sheath through a trans-atrial entry site directly into a left atrium of a heart of a patient;
• moving the distal end of the delivery sheath through the left atrium, through the left ventricle of the heart and out through an opening in an apex of the heart;
• after the moving, moving the prosthetic mitral valve distally out of the lumen of the delivery sheath such that the inverted outer frame of the prosthetic mitral valve reverts and the prosthetic mitral valve assumes its biased expanded configuration;
• withdrawing the dilator and guidewire from the delivery sheath;
• and
• positioning the prosthetic mitral valve within a mitral annulus of the heart.

A method, comprising:

• inverting an outer frame of a prosthetic mitral valve when the prosthetic mitral valve is in a biased expanded configuration, the prosthetic mitral valve being formed with a shape-memory material;
• after the inverting, inserting the prosthetic mitral valve into a lumen of a delivery sheath such that the prosthetic mitral valve is moved to a collapsed configuration, while remaining inverted;
• inserting the delivery sheath through a puncture site in a jugular vein of a patient, through the superior vena cava of the patient, and through the atrial septum wall of a heart of the patient and into the left atrium of the heart;
• inserting a catheter through an opening in an apex of the heart and positioning a distal end portion of the catheter in a left ventricle of the heart;
• inserting a snare device through the catheter and into the left ventricle
• capturing a distal portion of a tether coupled to the prosthetic valve with the snare device and pulling the portion of the tether through the catheter and outside of the heart;
• after the capturing, moving the prosthetic mitral valve distally out of the lumen of the delivery sheath such that the inverted outer frame of the prosthetic mitral valve reverts and the prosthetic mitral valve assumes its biased expanded configuration;
• and
• positioning the prosthetic mitral valve within a mitral annulus of the heart.

A method, comprising:

• inverting an outer frame of a prosthetic mitral valve when the prosthetic mitral valve is in a biased expanded configuration, the prosthetic mitral valve being formed with a shape-memory material;
• after the inverting, inserting the prosthetic mitral valve into a lumen of a delivery sheath such that the prosthetic mitral valve is moved to a collapsed configuration, while remaining inverted;
• disposing a dilator and guidewire within a lumen of the delivery sheath such that a portion of the dilator and a portion of the guidewire extend distally from the delivery sheath;
• after the disposing, inserting the delivery sheath through a puncture site in a jugular vein of a patient, through the superior vena cava of the patient, and through the atrial septum wall of a heart of the patient and into a left atrium of the heart;
• moving the distal end of the delivery sheath through the left atrium, through the left ventricle of the heart and out through an opening in an apex of the heart;
• withdrawing the dilator and guidewire from the delivery sheath;
• after the moving, moving the prosthetic mitral valve distally out of the lumen of the delivery sheath such that the inverted outer frame of the prosthetic mitral valve reverts and the prosthetic mitral valve assumes its biased expanded configuration;
• and
• positioning the prosthetic mitral valve within a mitral annulus of the heart.