Systems of heart valve delivery on a beating heart

A system for delivery of a prosthetic heart valve to a beating heart, comprising;

• a delivery catheter having a catheter tube and an expandable prosthetic heart valve disposed in a contracted state on the catheter tube just distal to a deflectable portion thereof, the delivery catheter also having a proximal control handle with a plurality of concentric tubes extending from within the control handle including the catheter tube, the proximal control handle having mounted on an exterior thereof both a deflection actuator for deflecting the deflectable portion of the catheter tube via a deflection pull wire and an actuator for moving one of the concentric tubes axially relative to the other concentric tubes, the deflection actuator and actuator being located so as to enable one handed operation of both;
• an introducer that receives the delivery catheter therethrough and has an elongated tubular sheath extending distally from a proximal housing containing a plurality of introducer valves for fluidly sealing around devices passed therethrough, the tubular sheath including a proximal segment extending a length of at least one half a total length L of the sheath and having a first stiffness, and a distal section having a length l of one half or less of the total length L of the sheath that has a second stiffness less than the first stiffness, the introducer having a length sufficient to extend from outside a patient through an intercostal incision and into the left ventricle of the patient;
• and
• a tubular loader defining a throughbore that receives a distal portion of the delivery catheter, and includes structure for engaging mating structure on a proximal end of the introducer housing and a distal nose that extends through and opens the introducer valves and facilitates passage therethrough of the delivery catheter, the loader having a proximal housing with a loader seal for fluidly sealing around the delivery catheter, and a single-handed vent for aspirating air from within the loader housing.