Method for delivery of prosthetic aortic valve

A method of implanting a prosthetic aortic valve in a native aortic valve of patient with a delivery sheath, the prosthetic aortic valve including a stent frame having an interior and three prosthetic valve leaflets mounted within the interior and joined at three respective commissures to provide unidirectional flow of blood through the prosthetic aortic valve, the stent frame further including a portion at a lower edge thereof, the method comprising:

• collapsing the prosthetic aortic valve into a collapsed configuration;
• loading the prosthetic aortic valve in the collapsed configuration into the delivery sheath so that a selected point on the prosthetic valve is rotationally aligned relative to a long axis of the delivery sheath with a selected radiopaque marker on the delivery sheath;
• introducing the delivery sheath along the long axis of the delivery sheath into a vasculature of the patient;
• advancing the delivery sheath until a distal end of the delivery sheath is disposed in an ascending aorta of the patient with the entire prosthetic aortic valve in a position above the native aortic valve;
• while the entire prosthetic aortic valve is in the position above the native aortic valve, fluoroscopically imaging the native aortic valve with a fluoroscopic camera;
• setting a position of the fluoroscopic camera to establish an imaging plane in which a selected point on the native aortic valve appears on a central axis of the image of the native aortic valve;
• after the advancing the delivery sheath, and while under the fluoroscopic imaging, and while the entire prosthetic aortic valve is in the position above the native aortic valve, rotating the delivery sheath about its long axis to align the selected radiopaque marker on the delivery sheath with the selected point on the native aortic valve in the imaging plane, thereby establishing a desired orientation of the prosthetic aortic valve with respect to the native aortic valve in which the prosthetic valve commissures are rotationally aligned with commissures of the native aortic valve;
• after the rotating the delivery sheath, further advancing the delivery sheath along its long axis until the prosthetic aortic valve is disposed inside the native aortic valve;
• and
• deploying the prosthetic aortic valve into an implanted state inside the native aortic valve with the prosthetic aortic valve aligned in the desired orientation with respect to the native aortic valve and with the portion of the stent frame disposed adjacent to the location of conduction tissue of the native aortic valve so that the frame does not damage the conduction tissue.