Devices, systems and methods for heart valve replacement

A method of treating a mitral valve of a patient, the mitral valve having an annulus and leaflets, the method comprising:

• implanting a device within or adjacent to the annulus, the device comprising a valve support and an expandable ring-shaped retainer positioned at an upstream end of the valve support, wherein at least the retainer is disposed between the leaflets, and wherein the retainer is configured to engage and seal with tissue on or near the annulus to prevent migration of the device in an upstream direction;
• wherein the upstream end of the valve support is radially inward from and longitudinally overlapping a portion of the retainer when the device is in a deployed configuration;
• and
• wherein the valve support is mechanically isolated from the retainer such that a cross-sectional shape of the valve support remains substantially cylindrical if the retainer is radially deformed into a non-circular shape by engagement with the tissue.

A method of treating a heart valve of a patient, the heart valve having an annulus and leaflets, the method comprising:

• positioning a prosthetic heart valve device between the leaflets and downstream of the annulus when the prosthetic heart valve device is in a delivery configuration, the prosthetic heart valve device comprising:
• an expandable valve support having an inflow end and an outflow end extending along a longitudinal axis, the expandable valve support having an outer surface and an inner surface, wherein the inner surface is configured to support a prosthetic valve, and wherein the expandable valve support has a cross-sectional shape;
• an expandable retainer coupled to and encircling the expandable valve support, the expandable retainer configured to engage and seal with tissue on or near the annulus on an inner or inflow side of the annulus or the leaflets;
• wherein the inflow end of the expandable valve support is radially inward from and longitudinally overlapping a portion of the expandable retainer when the prosthetic heart valve device is in a deployed configuration;
• and
• wherein the expandable valve support is mechanically isolated from the expandable retainer such that the cross-sectional shape of the expandable valve support remains substantially cylindrical such that the prosthetic valve remains competent when the expandable retainer is deformed into a non-circular shape by engagement with the tissue;
• expanding the prosthetic heart valve device from the delivery configuration to an expanded configuration with the expandable retainer extending between the leaflets;
• and
• moving the prosthetic heart valve device in an upstream direction to engage the tissue on or downstream of the annulus with the expandable retainer.