Devices, systems, and methods for deploying a transcatheter aortic valve implant within a surgical aortic valve implant

A transcatheter aortic valve replacement (TAVR) system, comprising:

• a pigtail catheter comprising an elongate shaft having a curled distal tip, a tubular sheath slidably disposed over the elongate shaft, and a compliant expandable member fixed to the elongate shaft and the tubular sheath;
• a TAVR delivery device comprising an elongate shaft having an implant holding portion proximate a distal end thereof;
• and
• a TAVR implant disposed within the holding portion in a collapsed configuration, the TAVR implant comprising an expandable framework including a lower crown disposed at an upstream end and an upper crown disposed downstream of the lower crown;
• wherein the compliant expandable member is configured to identify a downstream extent of a surgical aortic valve implant disposed within an ascending aorta prior to deploying the TAVR implant.

A method of deploying a transcatheter aortic valve replacement (TAVR) implant within a surgical aortic valve implant disposed within a native heart valve and an ascending aorta, comprising:

• advancing a pigtail catheter intravascularly to a position adjacent the surgical aortic valve implant, the pigtail catheter comprising a compliant expandable member proximate a curled distal tip thereof;
• positioning the curled distal tip of the pigtail catheter radially outward of the surgical aortic valve implant such that the curled distal tip is disposed between the surgical aortic valve implant and a wall of the ascending aorta;
• shifting the compliant expandable member from a collapsed configuration toward an expanded configuration with a portion of the compliant expandable member disposed between the surgical aortic valve implant and the wall of the ascending aorta;
• identifying a downstream extent of the surgical aortic valve implant disposed within the ascending aorta with the compliant expandable member using fluoroscopy;
• and
• deploying the TAVR implant within the surgical aortic valve implant at a desired position relative to the downstream extent of the surgical aortic valve implant.