A
delivery system and method for
percutaneous aortic valve (PAV) replacement and apparatus used therein. A temporary
aortic valve comprised of a reversibly expandable occluding means, such as balloons, surrounds a
central catheter mechanism. The temporary valve is positioned within the
ascending aorta, just above and downstream from the coronary ostia. The occluding means is configured such that, when fully expanded against the
aortic wall, gaps are left that promote continuous coronary
perfusion during the
cardiac cycle. The temporary valve with occluding means substitutes for the function of the native
aortic valve during its replacement. The native aortic valve is next dilated, and then ablated through deployment of low profile, elongated, sequentially delivered stents. The
ablation stent(s) displace the
native valve tissues and remain within the aortic annulus to receive and provide a structure for retaining the PAV. The PAV is delivered, positioned and deployed within the
ablation stent(s) at the aortic annulus with precision and relative ease.
Ablation of the native aortic valve removes the structural obstacles to precise PAV placement. The temporary aortic valve mediates the hemodynamic forces upon the devices as encountered by the surgeon following
native valve ablation. The temporary valve also promotes patient stability through continuous coronary
perfusion and a moderated transvalvular pressure gradient and regurgitation. Sequential delivery of low profile PAV components minimize the risk of trauma and injury to vascular tissues. Mathematical considerations for determining the optimum cross-sectional area for the temporary valve blood
perfusion gaps are also described.