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WO2025207668A1 - Delivery apparatus for a prosthetic valve - Google Patents

Delivery apparatus for a prosthetic valve

Info

Publication number
WO2025207668A1
WO2025207668A1 PCT/US2025/021393 US2025021393W WO2025207668A1 WO 2025207668 A1 WO2025207668 A1 WO 2025207668A1 US 2025021393 W US2025021393 W US 2025021393W WO 2025207668 A1 WO2025207668 A1 WO 2025207668A1
Authority
WO
WIPO (PCT)
Prior art keywords
shaft
balloon
delivery apparatus
examples
distal end
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/US2025/021393
Other languages
French (fr)
Inventor
Yidong M. ZHU
Biswa P. DAS
Michael R. Bialas
Katherine Elizabeth MESSER
JENNERSON (FORMERLY PITTNER), Ashley, Colette
Aaron Anthony CARLOS
Camille Lazaro VILLADOLID
Elizabeth Anne ANDERSON
Maximilian Thomas GRUBER
Andrew Christopher MEIGS
Kim Le
Andrew Steven ROUNDY
Daniel Kim
Cassandra Dieu TRAN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Edwards Lifesciences Corp
Original Assignee
Edwards Lifesciences Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Edwards Lifesciences Corp filed Critical Edwards Lifesciences Corp
Publication of WO2025207668A1 publication Critical patent/WO2025207668A1/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/243Deployment by mechanical expansion
    • A61F2/2433Deployment by mechanical expansion using balloon catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958Inflatable balloons for placing stents or stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0029Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in bending or flexure capacity

Definitions

  • valvular diseases can result in significant malfunctioning of the heart and ultimately require repair of the native valve or replacement of the native valve with an artificial valve.
  • repair devices e.g., stents
  • artificial valves as well as a number of known methods of implanting these devices and valves in humans.
  • Percutaneous and minimally- invasive surgical approaches are used in various procedures to deliver prosthetic medical devices to locations inside the body that are not readily accessible by surgery or where access without surgery is desirable.
  • the prosthetic valve can be mounted in a radially compressed state onto a delivery apparatus for delivery to a target implantation site and then deployed at the target implantation site (e.g., the native valve) with the delivery apparatus.
  • the delivery apparatus can include an inflatable balloon and the prosthetic valve can be radially expanded and deployed by inflating the balloon at the target implantation site.
  • the prosthetic valve is mounted off the inflatable balloon and then moved axially onto the balloon prior to deployment.
  • the delivery apparatus can include a torqueable shaft or shaft segment that connects a rotatable balloon shaft of the delivery apparatus to the inflatable balloon.
  • the torqueable shaft can, in some examples, comprise a tube with cuts or openings that allow it to bend (for example, when navigating through the patient’s vasculature) and also transfer torque from the balloon shaft to the distal end of the torqueable shaft, thereby enabling rotation the prosthetic valve mounted on the torqueable shaft.
  • the torqueable shaft can also be radially compressible, or have a small enough outer diameter such that when a prosthetic valve is crimped thereon, the integrity and durability of the prosthetic valve (e.g., the leaflets) is maintained and/or on overall crimp profile of the prosthetic valve is reduced.
  • the torqueable shaft or shaft segment can be an extension of a proximal end portion (or a proximal leg) of the inflatable balloon.
  • the extended proximal end portion of the inflatable balloon can comprise holes, cuts, or the like, that provide it with flexibility.
  • the torqueable shaft or shaft segment can be an extension of a layer or portion of the rotatable balloon shaft, such as a braided tube layer.
  • the prosthetic valve can be rotated into a desired position relative to the native anatomy prior to implantation. For example, the prosthetic valve can be rotated such that its commissures are rotationally aligned with commissures of a native heart valve.
  • a delivery apparatus for a prosthetic implant can comprise one more shafts.
  • the delivery apparatus can comprise a handle and the one or more shafts extend distally from the handle.
  • the one or more shafts includes a rotatable first shaft.
  • the first shaft has a smaller diameter portion and a larger diameter portion arranged between the handle and the smaller diameter portion.
  • the smaller diameter portion is configured to receive a prosthetic valve in a radially compressed configuration.
  • the one or more shafts includes a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft.
  • the delivery apparatus includes an inflatable balloon arranged around the distal end portion of the second shaft.
  • the inflatable balloon comprises an inflatable body arranged around the distal end portion of the second shaft and a proximal leg that extends toward or to the distal end of the first shaft.
  • the proximal leg of the balloon has a stiffness that enables it to transfer torque along its length and receive a prosthetic valve crimped thereon.
  • the proximal leg of the balloon has a plurality of longitudinal pleats.
  • the proximal leg comprises a plurality of through-holes spaced apart along its length, and the delivery apparatus comprises a crimp balloon surrounding the proximal leg.
  • the proximal leg comprises a plurality of axially spaced recesses extending into the shaft from its outer surface.
  • the delivery apparatus includes a third shaft having a first end coupled to the distal end of the first shaft.
  • the delivery apparatus includes a third shaft or shaft portion that extends distally outward from the first shaft.
  • the third shaft or shaft portion is a braided tube or braided layer of the first shaft.
  • the braided tube extends along the outer surface of the second shaft.
  • a proximal end of the inflatable balloon is coupled to the third shaft.
  • a second end of the third shaft is coupled to the proximal end of the inflatable balloon.
  • a polymeric body is mounted on the distal end of the second shaft and a second end of the third shaft is coupled to the polymeric body.
  • the polymeric body is a distal shoulder.
  • the delivery apparatus includes a crimp balloon extending between the first shaft and the inflatable balloon.
  • a support structure comprising a plurality of struts is bonded to a surface of the crimp balloon.
  • the third shaft extends over the crimp balloon.
  • the third shaft extends within the crimp balloon.
  • the third shaft comprises a plurality of openings or cuts along its length that allows it to bend and transfer torque from the first shaft to a second end of the third shaft.
  • the third shaft comprises a plurality of cuts that are organized into a plurality of axially spaced rows of cuts.
  • a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a third shaft comprising metal and having a first end coupled to the distal end of the first shaft. A proximal end of the inflatable balloon is coupled to the third shaft.
  • the second shaft extends through the third shaft and the third shaft comprises a plurality of repeating cuts spaced apart along the third shaft.
  • a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a braided tube comprising a first portion extending within the first shaft and a second portion that extends outward from a distal end of the first shaft to a proximal end of the inflatable balloon.
  • the second portion is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated.
  • a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft, and a support structure arranged along the crimp balloon.
  • the support structure comprises a plurality of spaced apart support struts extending along a surface of the balloon.
  • the first shaft has a first segment with a first diameter and a second segment with a second diameter that is smaller than the first diameter.
  • the first segment extends from the handle and defines a majority of a length of the first shaft.
  • the delivery apparatus further comprises a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, and an inflatable balloon arranged around the distal end portion of the second shaft.
  • the second segment of the first shaft extends from the first segment toward a proximal end of the inflatable balloon and is configured to receive a prosthetic valve in a radially compressed configuration.
  • a delivery apparatus comprises one or more of the components recited in Examples 1-30, 34-63, 66-86, 89-131, 134-184, or 186-213 below.
  • An assembly can comprise a prosthetic heart valve and the delivery apparatus described in any of the paragraphs above.
  • an assembly comprises one or more of the components recited in Examples 31-33, 64, 65, 87, 88, 132, 133, or 185 below.
  • the various innovations of this disclosure can be used in combination or separately. This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description.
  • FIG.4 is side view of a section of the handle and a section of the distal end portion of the delivery apparatus of FIG.2.
  • FIG.5A is a side view of the distal end portion of the delivery apparatus of FIG.2.
  • FIG.5B is a cross-sectional side view of the distal end portion of the delivery apparatus of FIG.2.
  • FIG.6 is a perspective view of an exemplary delivery apparatus including a shaft extending along a crimp balloon of the delivery apparatus and coupled between a balloon shaft and an inflation balloon of the delivery apparatus, where the shaft comprises puzzle- shaped cuts that allow it to bend and compress axially while also transferring torque from the balloon shaft to a distal end of the shaft.
  • FIG.7 is a detail view of a portion of the puzzle shaft of FIG.6 showing circumferentially extending rows of cuts that are spaced axially apart along the shaft, the cuts creating puzzle-shaped connections between adjacent sections of the shaft, thereby enabling the shaft to bend and compress in the axial direction.
  • FIG.8 is a side view of the puzzle shaft of FIG.6 in a flattened configuration.
  • FIG.9 is a perspective view of the puzzle shaft of FIG.6, showing end portions of the puzzle shaft comprising attachment interfaces that are configured to couple to the balloon shaft and inflatable balloon.
  • FIG.10 is a perspective view of a portion of the delivery apparatus of FIG.6 that includes the shaft of FIG.6 extending underneath the crimp balloon and coupled to the balloon shaft and inflatable balloon.
  • FIG.11A is a perspective view of a portion of the delivery apparatus of FIG.10 showing a distal attachment interface of the shaft coupled to a proximal end portion of the inflatable balloon.
  • FIG.11B is a perspective view of the portion of the delivery apparatus of FIG.11A showing the crimp balloon over the shaft and a polymer reflowed over the inflatable balloon, shaft, and crimp balloon to seal them together.
  • FIG.12 is a perspective view of a portion of the delivery apparatus of FIG.19 showing a proximal attachment interface of the shaft coupled to a distal end of the balloon shaft.
  • FIG.13 is a perspective view of an exemplary delivery apparatus including a crimp balloon shaft having a body similar to the shaft of FIGS.7-9; however, the shaft shown in FIG.13 is longer and extends through the inflation balloon to a distal end of the delivery apparatus.
  • FIG.14 is a perspective view of an exemplary delivery apparatus including a shaft extending along a crimp balloon of the delivery apparatus and coupled between a balloon shaft and an inflation balloon of the delivery apparatus, where the shaft comprises axially spaced rows of circumferential cuts that allow it to bend while also transferring torque from the balloon shaft to a distal end of the shaft.
  • FIG.15 is a detail view of a portion of the shaft of FIG.14 in a flattened configuration, showing circumferentially extending rows of circumferential cuts that are spaced axially apart along the shaft, where each row comprises circumferential cuts spaced apart around the shaft.
  • FIG.16 is a side view of the shaft of FIG.14 in a flattened configuration, the shaft having proximal and distal attachment interfaces that are configured to attach to the balloon shaft and inflation balloon of the delivery apparatus, respectively.
  • FIG.17 is a perspective view of a portion of the delivery apparatus of FIG.14 showing the proximal and distal attachment interfaces of the shaft coupled to the balloon shaft and the inflation balloon of the delivery apparatus, respectively.
  • FIG.18 is a side view of an exemplary crimp balloon shaft in a flattened configuration, wherein the shaft includes a first section that is configured to extend between a balloon shaft and inflation balloon of a delivery apparatus and comprises circumferential cuts and a second section that is configured to extend along the inflation balloon to a distal end of the delivery apparatus and comprises circumferentially extending puzzle cuts.
  • FIG.19 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts.
  • FIG.20 depicts an exemplary cut pattern for a crimp balloon shaft that comprises angled or spiral cuts.
  • FIG.21 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with wider end portions.
  • FIG.22 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with teardrop shaped end portions.
  • FIG.23 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with hammerhead shaped end portions.
  • FIG.24 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with wider end portions and triangular cuts protruding from the body of the cut.
  • FIG.25 depicts an exemplary cut pattern for a crimp balloon shaft that comprises cuts having a wider body and narrower end portions.
  • FIG.26 is a side view of an exemplary crimp balloon shaft for a delivery apparatus, the shaft comprising a body with a plurality of circumferentially extending rows of cuts and tubular end portions that each comprise a plurality of openings.
  • FIG.27A is a perspective view of an exemplary crimp balloon shaft for a delivery apparatus, the shaft comprising a body with a plurality of circumferentially extending rows of cuts and tapered end portions that comprise a polymer.
  • FIG.27B is a perspective view of the shaft of FIG.27A coupled to a balloon shaft and inflation balloon of an exemplary delivery apparatus.
  • FIG.28 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with curved end portions.
  • FIG.29 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with hooked end portions.
  • FIG.30 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with flared end portion that extend from a lattice structure of the attachment interface.
  • FIG.31 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having an elongated slot.
  • FIG.32 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having a relatively large opening at its distal end.
  • FIG.33 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having a relatively large opening at its distal end and a wider leg portion.
  • FIG.34 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising a tubular body with a plurality of openings.
  • FIG.35 is a side view of an exemplary crimp balloon shaft comprising a plurality of interconnected struts forming alternating sections of lattice structure that provide bendability and radial compressibility to the shaft.
  • FIG.36 is a flattened view of a portion of the shaft of FIG.35.
  • FIG.37 is a perspective view of the shaft of FIG.35 connected to a balloon shaft of a delivery apparatus and bent at its bendable sections.
  • FIG.38 is a view of an exemplary crimp balloon shaft in a flattened configuration, the shaft comprising struts that form a diamond lattice structure.
  • FIG.46C is a perspective view of an exemplary puzzle shaft comprising a plurality of cuts where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus.
  • FIG.46D is a perspective view of a shaft comprising a braided mesh body, where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus.
  • FIG.46E is a perspective view of a coil spring shaft, where the coil spring shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus.
  • FIG.47B is a perspective view of a crimp balloon being arranged over the coil spring shaft of FIG.47A.
  • FIG.47C is a perspective view of another end portion of the coil spring shaft of FIG. 47B being arranged within a distal end of a balloon shaft of the delivery apparatus.
  • FIG.47D is a perspective view of portion of the delivery apparatus of FIG.47C in a bent configuration.
  • FIG.48 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus, the balloon having an elongated proximal leg comprising a plurality of through-holes along its length, where the proximal leg is configured to extend underneath a crimp balloon and toward a balloon shaft of the delivery apparatus.
  • FIG.49 is a partial side view of the proximal leg of the balloon of FIG.45 showing a spiral arrangement of the holes in the proximal leg.
  • FIG.50 is a partial side view of the proximal leg of FIG.50 with a crimp balloon arranged over the proximal leg and prosthetic valve crimped on the crimp balloon and proximal leg.
  • FIG.51 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus, the balloon having an elongated proximal leg comprising a plurality of spaced apart recesses along its length, where the proximal leg is configured to extend to a balloon shaft of the delivery apparatus and receive a prosthetic device crimped thereon.
  • FIG.52A is a cross-sectional view of a portion of the proximal leg of the balloon of FIG.51 depicting the recesses which create areas of high and low outer diameters along the length of the proximal leg.
  • FIG.52B is a cross-sectional view of a portion of the proximal leg of the balloon of FIG.51 depicting the recesses which create areas of high and low outer diameters along the length of the proximal leg and a polymeric sleeve over an outer surface of the proximal leg.
  • FIG.53 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus and a flexible shaft coupled to a proximal leg of the balloon, where the flexible shaft is configured to a balloon shaft of the delivery apparatus and receive a prosthetic device crimped thereon.
  • FIG.54 is an exemplary longitudinal cross-section of a portion of the flexible shaft of FIG.53, according to an example where the shaft has inner corrugations extending from a central lumen of the flexible shaft.
  • FIG.55A is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen and a plurality of offset lumens spaced apart from one another around the central lumen.
  • FIG.55B is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen and a plurality of offset lumens spaced apart from one another around the central lumen.
  • FIG.55C is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen, a plurality of offset first lumens spaced apart from one another around the central lumen, and a plurality of offset second lumens spaced apart from one another around the first lumens.
  • FIG.56A depicts an exemplary inflatable balloon in an at least partially inflated state, where the inflatable balloon includes a proximal leg comprising a plurality of longitudinal pleats.
  • FIG.56B depicts the inflatable balloon of FIG.56A in a deflated state.
  • FIG.57A is a cross-sectional view of a distal end portion of delivery apparatus, depicting a first braided layer of a balloon shaft of the delivery apparatus extending outward from a distal end of the balloon shaft to an inflatable balloon of the delivery apparatus, with a crimp balloon arranged around the portion of the first braided layer extending outward from the balloon shaft.
  • FIG.57B is a side view of the distal end portion of the delivery apparatus of FIG.57A with the crimp balloon removed.
  • FIG.57C is a side view of the distal end portion of the delivery apparatus of FIG.57B with the crimp balloon arranged over the first braided layer between the balloon shaft and the inflatable balloon.
  • FIG.58 is a cross-sectional view of a distal end portion of delivery apparatus, depicting a first braided layer of a balloon shaft of the delivery apparatus extending outward from a distal end of the balloon shaft and tapering radially inward to an inner shaft of the delivery apparatus, where the first braided layer extends along an outer surface of the inner shaft to an inflatable balloon of the delivery apparatus.
  • FIG.59A is a side view of the distal end portion of the delivery apparatus of FIG.58.
  • FIG.59B is a side view of the distal end portion of the delivery apparatus of FIG.58 with a crimp balloon arranged around the first braided layer extending along the inner shaft.
  • FIG.60 is a cross-sectional view of a distal end portion of delivery apparatus, depicting a stepped braided layer extending from within a balloon shaft of the delivery apparatus to an inner shaft of the delivery apparatus.
  • FIG.61A depicts the stepped braided layer of FIG.60, which includes a larger diameter portion, a smaller diameter portion that extends over the inner shaft, and a stepped transition portion extending between the larger and smaller diameter portions.
  • FIG.61B depicts the stepped braided layer of FIG.61A, with the larger diameter portion extending outward from a distal end of the balloon shaft.
  • FIG.64 is a side schematic view of a balloon shaft comprising a main, larger diameter section extending from a handle of a delivery apparatus, a second larger diameter section extending from an inflatable balloon of the delivery apparatus, and a smaller diameter section extending between the main, larger diameter section and the second larger diameter section, where the smaller diameter section is configured to receive a prosthetic valve radially compressed directly thereon.
  • FIG.65A is a side view of a delivery apparatus including the balloon shaft of FIG.64.
  • FIG.65B is a portion of the balloon shaft of FIG.65A, depicting the smaller diameter section extending between the main, larger diameter section and the second larger diameter section.
  • FIG.69 is a detail view of an exemplary pattern of cuts for the metal tube of FIG.67.
  • FIG.70 is a side view of an exemplary shaft for a delivery apparatus that is configured to extend along a crimp balloon of the delivery apparatus and be coupled between a balloon shaft and an inflation balloon of the delivery apparatus at respective attachment interfaces of the shaft, where the shaft comprises a metal tube with openings cut therein.
  • FIG.71 depicts the distal attachment interface of the shaft of FIG.70 in a flattened configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon.
  • FIG.72A depicts the distal attachment interface of the shaft of FIG.70 in a radially collapsed configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon.
  • FIG.72B depicts the distal attachment interface of the shaft of FIG.70 in a radially expanded (or flared) configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon.
  • FIGS.73A-73D depict an exemplary process for manufacturing a distal attachment interface of a shaft for a delivery apparatus, such as the shaft of FIG.70, and flaring and bonding the distal attachment interface to an inflation balloon of the delivery apparatus.
  • FIG.75B depicts the attachment interface of FIG.75A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends.
  • FIG.76A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with cells defining the free end of the attachment interface comprising cut outs that are configured such that the attachment interface is radially collapsable after flaring.
  • FIG.76B depicts the attachment interface of FIG.76A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends.
  • FIGS.78A-78D depict an exemplary process for manufacturing a proximal attachment interface of a shaft for a delivery apparatus, such as the shaft of FIG.70, and flaring and bonding the proximal attachment interface to a balloon shaft of the delivery apparatus.
  • FIG.79 depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a tapered lattice structure.
  • FIG.80 depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure configured to prevent over expansion of the attachment interface.
  • FIG.82A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with a first rows of cells at the free end that are each bisected by an axially extending strut.
  • FIG.82B depicts the attachment interface of FIG.82A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends.
  • FIG.83A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure that is configured to provide increased strength in the flared configuration.
  • FIG.83B depicts the attachment interface of FIG.83A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends.
  • proximal refers to a position, direction, or portion of a device that is closer to the user and further away from the implantation site.
  • distal refers to a position, direction, or portion of a device that is further away from the user and closer to the implantation site.
  • proximal motion of a device is motion of the device away from the implantation site and toward the user (e.g., out of the patient’s body), while distal motion of the device is motion of the device away from the user and toward the implantation site (e.g., into the patient’s body).
  • Prosthetic valves disclosed herein can be radially compressible and expandable between a radially compressed state and a radially expanded state.
  • the prosthetic valves can be crimped on or retained by an implant delivery apparatus in the radially compressed state while being advanced through a patient’s vasculature on the delivery apparatus.
  • the prosthetic valve can be expanded to the radially expanded state once the prosthetic valve reaches the implantation site.
  • prosthetic valves disclosed herein may be used with a variety of implant delivery apparatuses and can be implanted via various delivery procedures, examples of which will be discussed in more detail later.
  • rotating the prosthetic valve with the delivery apparatus can allow for commissures of the prosthetic valve to be rotationally aligned with commissures of the native valve, thereby improving the performance of the implanted prosthetic heart valve, improving the function of the native anatomy, and/or enabling future interventional procedures that require access to coronary arteries or the valve leaflet.
  • the prosthetic valve for delivery of the prosthetic valve to a target implantation site, can be initially radially compressed and mounted at a location that is axially offset from the central section of the inflatable balloon, such as around a crimp balloon or relatively thin piece of tubing that connects a distal end of the balloon shaft of the delivery apparatus to a proximal end of the inflatable balloon.
  • the crimp balloon gives the prosthetic valve a smaller-diameter inner member to mount onto, thereby reducing the overall crimp profile of the prosthetic valve and push forces and making it easier to navigate the prosthetic valve through a patient’s vasculature using the delivery apparatus.
  • a more rigid tube comprising a pattern of small cuts or a plurality of openings can be used to connect the balloon shaft to the inflatable balloon, and the prosthetic valve can be mounted thereon for delivery to an implantation site.
  • the more rigid tube can be a metal tube comprising a pattern of small cuts along its length (for example, laser cuts), or a pattern of open cells formed by struts of the metal tube, thereby allowing the tube to bend as the delivery apparatus navigates through bends in the patient’s vasculature, while also allowing the tube to effectively transfer torque from the balloon shaft to a proximal end of the inflatable balloon.
  • the more rigid tube can be an extension of a braided layer of the balloon shaft.
  • the more rigid tube can be an extension of the proximal leg of the inflatable balloon and can comprise holes, slits, cuts, or pleats.
  • the more rigid tube can be a polymeric shaft with axially extending holes or channels, or radially extending recesses, that provide the tube with flexibility, while still allowing it to transfer torque.
  • FIG.1 is an exemplary prosthetic valve that can be mounted on and delivered by a delivery apparatus, such as the delivery apparatus shown in FIGS.2-5B.
  • the delivery apparatus comprises a crimp balloon that extends between a distal end of a balloon shaft of the delivery apparatus and a proximal end of the inflatable balloon of the delivery apparatus (as shown in FIG.5B).
  • the crimp balloon can be configured to receive a prosthetic valve radially compressed thereon, as shown in FIG.5A.
  • FIGS.6-18, 35-37, and 45-47C show various examples of shafts that can be mounted over or underneath a crimp balloon and transfer torque from the balloon shaft to a proximal end of the inflatable balloon which is attached to the shaft.
  • the shafts can have various openings, cuts, slots, or the like, that provide flexibility to the shaft.
  • FIGS.6-13 depict an exemplary crimp balloon shaft comprising a plurality of circumferentially extending, puzzle-shaped cuts that allow the shaft to compress axially, bend, and transfer torque. Another example of a puzzle-shaped cut design is shown in FIG. 46C.
  • the crimp balloon shaft extends between the balloon shaft and the proximal end of the inflatable balloon (as shown in FIG.6). In some examples, the crimp balloon shaft extends between the balloon shaft and through the inflatable balloon to a polymeric body mounted on a distal end portion of an inner shaft of the delivery apparatus (as shown in FIG.13).
  • FIGS.14-17 depict an exemplary crimp balloon shaft comprising a plurality of circumferentially extending rows of circumferential cuts, where the rows are spaced axially apart along the shaft.
  • FIGS.19-25 depict alternate shapes and arrangements of the cuts.
  • FIG.18 depicts an exemplary crimp balloon shaft that comprises a first section with the puzzle-shaped cuts and a second section with the circumferential cuts, where the first section is configured to extend underneath the inflatable balloon of the delivery apparatus.
  • Crimp balloon shafts can include attachment interfaces at their opposing ends that are configured to enhance coupling to the balloon shaft (at the proximal end) and either the inflatable balloon or the polymeric body of the delivery apparatus (at the distal end).
  • FIGS. 26-34 depict various examples of attachment interfaces for any of the crimp balloon shafts described herein.
  • FIG.70 depicts an exemplary crimp balloon shaft that comprises a metal and has opposing end portions defining first and second attachment interfaces and a body extending between the first and second attachment interfaces.
  • the first attachment interface is configured to couple to a balloon shaft of the delivery apparatus and the second attachment interface is configured to couple to an inflation balloon of the delivery apparatus.
  • the first and second attachment interfaces comprise a lattice structure that is configured to be flared radially outward for attachment to the inflation balloon or balloon shaft.
  • FIGS.73A-73D and 78A-78D Exemplary processes for bonding the various attachment interfaces to either the inflation balloon of the balloon shaft are shown in FIGS.73A-73D and 78A-78D.
  • FIGS.35-37 depict an exemplary balloon shaft comprising a plurality of interconnected struts forming alternating sections of lattice structure that provide bendability and radial compressibility to the shaft.
  • FIGS.38-44 show various additional examples of crimp balloon shafts comprising a plurality of interconnected struts forming one or more lattice structures.
  • the cusp edge portion of the leaflets 112 can have an undulating, curved scalloped shape, and can be secured (for example, by sutures) to an inner skirt 124 which is then secured to the frame 102 (such as with sutures 126). [0209] In some examples, the cusp edge portion of the leaflets 112 can be secured directly to the frame 102 (for example, by sutures). [0210] In some examples, the leaflets 112 can be formed of pericardial tissue (for example, bovine pericardial tissue), biocompatible synthetic materials, or various other suitable natural or synthetic materials as known in the art and described in U.S. Patent No.6,730,118, which is incorporated by reference herein.
  • the frame 102 can comprise three rows of cells 118 with a first (upper in the orientation shown in FIG.1) row of cells 120 disposed at the outflow end 110.
  • the first row of cells 120 comprises cells 118 that are elongated in an axial direction (relative to a central longitudinal axis 122 of the frame 102), as compared to cells 118 in the remaining rows of cells.
  • the cells 118 of the first row of cells 120 can have a longer axial length than cells 118 in the remaining rows of cells.
  • each row of cells comprises nine cells 118.
  • the frame 102 can be referred to as a nine-cell frame.
  • the frame 102 can comprise more than three rows of cells (for example, four or five) and/or more or less than nine cells per row.
  • the cells 118 in the first row of cells 120 may not be elongated compared to cells 118 in the remaining rows of cells of the frame 102.
  • the interconnected struts 116 can include a plurality of angled struts 130 arranged in a plurality of rows of circumferentially extending rows of angled struts, with the rows being arrayed along the length of the frame 102 between the outflow end 110 and the inflow end 108.
  • the interconnected struts 116 can also include a plurality of axially extending window struts 138 (or window strut portions) and a plurality of axial (or axially extending) struts 140.
  • the axially extending window struts 138 (which can also be referred to as axial struts that include a commissure window) define commissure windows (for example, open windows) 142 that are spaced apart from one another around the frame 102, in a circumferential direction, and which are adapted to receive a pair of commissure tabs of a pair of adjacent leaflets 112 arranged into a commissure (for example, commissure 114).
  • commissure windows 142 and/or the axially extending window struts 138 defining the commissure windows 142 can be referred to herein as commissure features or commissure supports, each commissure feature or support configured to receive and/or be secured to a pair of commissure tabs of a pair of adjacent leaflets.
  • One or more (for example, two, as shown in FIG.1) axial struts 140 can be positioned between, in the circumferential direction, two commissure windows 142 formed by the window struts 138.
  • each cell 118 can have an increased width (in the circumferential direction), thereby providing a larger opening for blood flow and/or coronary access.
  • Each axial strut 140 and each window strut 138 forms an axial side of two adjacent cells of the first row of cells 120.
  • Commissure tabs 115 of adjacent leaflets 112 can be secured together to form commissures 114 (FIG.1).
  • Each commissure 114 of the prosthetic heart valve 100 comprises two commissure tabs 115 paired together, one from each of two adjacent leaflets 112, and extending through a commissure window 142 of the frame 102.
  • Each commissure 114 can be secured to the window struts 138 forming the commissure window 142.
  • the cusp edge portion (for example, scallop edge) of each leaflet 112 can be secured to the frame 102 via one or more fasteners (for example, sutures). In some examples, the cusp edge portion of each leaflet 112 can be secured directly to the struts of the frame 102.
  • the cusp edge portion of the leaflets 112 can be secured to an inner skirt and the inner skirt can then be secured directly to the frame 102.
  • Various methods for securing the leaflets 112 to a frame, such as the frame 102, are disclosed in U.S. provisional patent applications 63/278,922, filed November 12, 2021, and 63/300,302, filed January 18, 2022, both of which are incorporated by reference herein.
  • the frame 102 can further comprise a plurality of apex regions 152 formed at the inflow end 108 and the outflow end 110, each apex region 152 extending and forming a junction between two angled struts 130 at the inflow end 108 or outflow end 110. As such, the apex regions 152 are spaced apart from one another, in a circumferential direction at the inflow end 108 and the outflow end 110. Additional details and examples of frames for prosthetic heart valves that include apex regions can be found in PCT Application No. PCT/US2022/025687, which is incorporated by reference herein.
  • FIGS.2-5B show a delivery apparatus 200, according to an example, that can be used to implant an expandable prosthetic heart valve (for example, the prosthetic heart valve 100 of FIG.1).
  • the delivery apparatus 200 is specifically adapted for use in introducing a prosthetic valve into a heart.
  • the delivery apparatus 200 generally includes a steerable guide catheter 214, and a balloon catheter 216 extending through the guide catheter 214.
  • the guide catheter 214 an also be referred to as a flex catheter or a main catheter.
  • the use of the term “main catheter” should be understood, however, to include flex or guide catheters, as well as other catheters or shafts that do not have the ability to flex or guide through a patient’s vasculature.
  • the guide catheter 214 and the balloon catheter 216 in the illustrated example are adapted to slide longitudinally relative to each other to facilitate delivery and positioning of a prosthetic valve 212 (which may be the prosthetic valve 100 of FIG.1, in some examples) at an implantation site in a patient’s body, as described further below.
  • the guide catheter 214 includes a handle portion 220 (as shown in FIGS.2-3B) and an elongated guide tube, or shaft, 222 extending from handle portion 220 (FIG.3A, 4, and 5).
  • FIG.2 shows the delivery apparatus without the guide catheter shaft 222 for purposes of illustration.
  • FIG.4 shows the guide catheter shaft 222 extending from the handle portion 220 over the balloon catheter.
  • This lower profile permits the user to more easily navigate the delivery apparatus (including crimped valve 212) through a patient’s vasculature to the treatment location.
  • the lower profile of the crimped prosthetic valve is particularly helpful when navigating through portions of the patient’s vasculature which are particularly narrow, such as the iliac artery.
  • the lower profile also allows for treatment of a wider population of patients.
  • a nose cone 232 (FIG.54) (or nose cone) can be mounted at the distal end of the delivery apparatus 200 to facilitate advancement of the delivery apparatus 200 through the patient’s vasculature to the implantation site.
  • the balloon catheter 216 can include an inner shaft 234 that extends from the proximal portion 224 and coaxially through the outer balloon catheter shaft 226 (which can also be referred to as an “outer shaft”) and the balloon 228.
  • the nose cone 232 can be mounted on a distal end portion of the inner shaft 234.
  • the nose cone 232 includes or is coupled to a distal shoulder 233 (which may be a polymeric body), which in turn is mounted on the distal end portion of the inner shaft 234, as shown in FIG.5B.
  • a mounting member 235 can be arranged around the inner shaft 234, within the balloon 228, to help secure a prosthetic valve on the balloon 228 once positioned there, as described herein (as shown in FIG.5B).
  • the outer balloon catheter shaft 226 and equivalent shafts are generally referred to as “balloon shafts” or “balloon catheter shafts”.
  • the balloon 228 can be supported on a distal end portion of inner shaft 234 that extends outwardly from and distal to the outer shaft 226, with a proximal end portion 236 of the balloon 228 secured to the distal end of the outer shaft 226 (FIG.2).
  • the outer diameter of inner shaft 234 is sized such that an annular space is defined between the inner shaft 234 and the outer shaft 226 along the entire length of the outer shaft 226.
  • the proximal portion 224 of the balloon catheter can be formed with a fluid passageway (not shown) that is fluidly connectable to a fluid source (e.g., saline or another inflation fluid) for inflating the balloon.
  • a fluid source e.g., saline or another inflation fluid
  • the fluid passageway is in fluid communication with the annular space between inner shaft 234 and outer shaft 226 such that fluid from the fluid source can flow through fluid passageway, through the space between the shafts, and into balloon 228 to inflate the same and deploy prosthetic valve 212.
  • the proximal portion 224 also defines an inner lumen that is in communication with a lumen 238 of the inner shaft 234 that is sized to receive guide wire (not shown) that can extend coaxially through the inner shaft 234 and the nose cone 232.
  • the inner shaft 234 and balloon catheter shaft 226 (or outer shaft) of the balloon catheter can be formed from any of various suitable materials, such as nylon, braided stainless steel wires, or a polyether block amide (commercially available as Pebax ® ).
  • the shafts 226, 234 can have longitudinal sections formed from different materials in order to vary the flexibility of the shafts along their lengths.
  • the inner shaft 234 can have an inner liner or layer formed of Teflon ® to minimize sliding friction with a guide wire.
  • the distal end portion of the guide catheter shaft 222 comprises a steerable section 268 (FIG.4), the curvature of which can be adjusted by the operator to assist in guiding the apparatus through the patient’s vasculature, and particularly the aortic arch.
  • the handle portion 220 (or handle 220) in the illustrated example comprises a distal handle portion 246 and a proximal handle portion 248.
  • the distal handle portion 246 functions as a mechanism for adjusting the curvature of the distal end portion of the guide catheter shaft 222 and, in some examples, as a flex indicating device that allows a user to measure the relative amount of flex of the distal end of the guide catheter shaft 222.
  • the flex indicating device can provide a visual and tactile response at the handle the device, which provides a user with an immediate and direct way to determine the amount of flex of the distal end of the catheter.
  • the distal handle portion 246 can be operatively connected to the steerable section 268 and functions as an adjustment mechanism to permit operator adjustment of the curvature of the steerable section via manual adjustment of the handle portion.
  • the handle portion 246 can comprise a flex activating member 250, an indicator pin 252, and a cylindrical main body, or housing 254. As shown in FIGS.3A and 3B, the flex activating member 250 comprises an adjustment knob 256 and a shaft 258 extending proximally from the knob into the housing 254.
  • a proximal end portion of the guide catheter shaft 222 extends into and is fixed within the central lumen of the housing 254.
  • An inner sleeve 270 surrounds a portion of the guide catheter shaft 222 inside the housing 254.
  • a threaded slide nut 272 is disposed on and is slidable relative to the sleeve 270.
  • the slide nut 272 is formed with external threads that mate with internal threads 260 of the shaft 258.
  • the slide nut 272 can be formed with two slots formed on the inner surface of the nut and extending the length thereof.
  • the sleeve270 can be formed with longitudinally extending slots that are aligned with the slots of the slide nut 272 when the slide nut is placed on the sleeve.
  • a respective elongated nut guide Disposed in each slot is a respective elongated nut guide, which can be in the form of an elongated rod or pin 276.
  • the pins 276 extend radially into respective slots in the slide nut 272 to prevent rotation of the slide nut 272 relative to the sleeve 270.
  • rotation of the adjustment knob 256 causes the slide nut 272 to move longitudinally relative to the sleeve 270 in the directions indicated by double-headed arrow 274 (FIG.3B).
  • One or more pull wires 278 (FIG.3A) couple the adjustment knob 256 to the steerable section 268 to adjust the curvature of the steerable section upon rotation of the adjustment knob.
  • the proximal end portion of the pull wire 278 can extend into and can be secured to a retaining pin, such as by crimping the pin around the proximal end of the pull wire, which pin is disposed in a slot in the slide nut 272.
  • the pull wire can extend from the pin, through the slot in the slide nut, a slot in the sleeve 270, and into and through a pull wire lumen in the shaft 222.
  • the distal end portion of the pull wire is secured to the distal end portion of the steerable section 268.
  • the pin, which retains the proximal end of the pull wire 278, is captured in the slot in the slide nut 272.
  • the pull wire when the adjustment knob 256 is rotated to move the slide nut 272 in the proximal direction, the pull wire also is moved in the proximal direction.
  • the pull wire pulls the distal end of the steerable section 268 back toward the handle portion, thereby bending the steerable section and reducing its radius of curvature.
  • the friction between the adjustment knob 256 and the slide nut 272 is sufficient to hold the pull wire taut, thus preserving the shape of the bend in the steerable section if the operator releases the adjustment knob 256.
  • the adjustment knob 256 is rotated in the opposite direction to move the slide nut 272 in the distal direction, tension in the pull wire is released.
  • the resiliency of the steerable section 268 causes the steerable to return its normal, non- deflected shape as tension on the pull wire is decreased. Because the pull wire is not fixedly secured to the slide nut 272 (the pin can move within the slot in the nut), movement of the slide nut in the distal direction does not push on the end of the pull wire, causing it to buckle. Instead, the pin is allowed to float within the slot of the slide nut 272 when the knob 256 is adjusted to reduce tension in the pull wire, preventing buckling of the pull wire. [0244] In some examples, the steerable section 268 in its non-deflected shape is slightly curved and in its fully curved position, the steerable section generally conforms to the shape of the aortic arch.
  • the steerable section can be substantially straight in its non-deflected position.
  • the distal handle portion 246 can have other configurations that are adapted to adjust the curvature of the steerable section 268.
  • One such alternative handle configuration is shown in U.S. Publication No.2007/0005131, which is incorporated by reference herein in its entirety. Additional details relating to the steerable section and handle configuration discussed above can be found in U.S. Patent Publication No. US2008/0065011 and US2013/0030519, which are incorporated by reference herein in their entireties.
  • the shaft 258 can also include an externally threaded surface portion 262.
  • a base portion 264 of the indicator pin 252 mates with the externally threaded surface portion 262 of the shaft 258.
  • the shaft 258 extends into the housing 254 and the indicator pin 252 is trapped between the externally threaded surface portion 262 and the housing 254, with a portion of the indicator pin 252 extending into a longitudinal slot 266 of the handle.
  • the knob 256 rotated to increase the curvature of the distal end of the guide catheter shaft 222, the indicator pin 252 tracks the external threaded portion 262 of the flex activating member and moves in the proximal direction inside of the slot 266.
  • Such indicia can identify the amount of flex in any of a variety of manners.
  • the outer surface of the housing 254 can include a series of numbers (for example, 0 to 10) adjacent the slot that indicate the amount of curvature of the guide catheter shaft 222 based on the position of the indicator pin 252 relative to the number scale.
  • a crimped (or radially compressed) prosthetic valve 212 is positioned proximal to the balloon 228 (FIG.5A).
  • the delivery apparatus 200 includes a relatively thin piece of tubing or a sleeve, which can be referred to herein as a crimp balloon 225 (the crimp balloon 225 is also depicted schematically in FIG.45), that couples a distal end of the balloon catheter shaft 226 to a proximal end (which may include and be referred to as a proximal leg 231) of the inflatable balloon 228. Examples of such an arrangement are described below with reference to FIGS.6-44.
  • the crimp balloon 225 can be made of any of various polymers traditionally used for forming medical balloons (e.g., nylon, Pebax, etc.).
  • the crimp balloon 225 and the balloon 228 are made of the same material.
  • the crimp balloon 225 can be at least partially inflated with an inflation fluid to partially expand a prosthetic valve mounted thereon prior to repositioning the prosthetic valve onto the balloon 228, as further described below.
  • the prosthetic valve 212 Prior to expansion of the balloon 228 and deployment of prosthetic valve 212 at the treatment site, the prosthetic valve 212 is moved axially relative to the balloon (or vice versa) to position the crimped prosthetic valve on the balloon 228 for deploying (expanding) the prosthetic valve.
  • the proximal handle portion 248 can serve as an adjustment device that can be used to move the balloon 228 proximally into position within the frame of prosthetic valve 212, and further to accurately position the balloon and the prosthetic valve at the desired deployment location.
  • the proximal handle portion 248 comprises an outer housing 280 and an adjustment mechanism 282.
  • the adjustment mechanism 282 which is configured to adjust the axial position of the balloon catheter shaft 226 relative to the guide catheter shaft 222, comprises an adjustment knob 284 and a shaft 286 extending distally into the housing 280.
  • the inner shaft 290 is mounted within the housing 280 on the balloon catheter shaft 226 .
  • the inner shaft 290 has a distal end portion 292 formed with external threads that mate with internal threads 294 that extend along the inner surface of the adjustment mechanism 282.
  • the inner shaft 290 further includes a proximal end portion 296 that mounts a securement mechanism 298, which is configured to retain the position of the balloon catheter shaft 226 relative to the proximal handle portion 248 for use of the adjustment mechanism 282, as further described below.
  • the inner shaft 290 can be coupled to the inner support 288 such that rotation of shaft 286 causes the inner shaft 290 to move axially within the handle.
  • the inner support 288 can have an axially extending rod or rail that extends into slot formed in the inner surface of the inner shaft 290.
  • the rod or rail prevents rotation of the inner shaft 290 but allows it to move axially upon rotation of the shaft 286.
  • the securement mechanism 298 includes internal threads that mate with external threads of the proximal end portion 296 of the inner shaft.
  • a pusher element 210 and a shaft engagement member in the form of a collet 202 is mounted within the proximal end portion 296 on the balloon catheter shaft 226 .
  • the collet 202 applies little, if any, force against the balloon catheter shaft 226, which can slide freely relative to the collet 202, the entire handle portion 220, and the guide catheter shaft 222.
  • the securement mechanism 298 When the securement mechanism 298 is rotated so as to move to its distal position closer to knob 284, the securement mechanism urges pusher element 210 against the proximal end of the collet 202.
  • the holding force of the collet 202 against the balloon catheter shaft 226 locks the balloon catheter shaft 226 relative to the inner shaft 290.
  • the adjustment knob 284 In the locked position, rotation of the adjustment knob 284 causes the inner shaft 290, the inner shaft 234, and the balloon catheter shaft 226 to move axially relative to the guide catheter shaft 222 (either in the proximal or distal direction, depending on the direction the knob 284 is rotated).
  • the adjustment knob 284 can be utilized to position the prosthetic valve 212 on the balloon 228 and/or once the prosthetic valve 212 is on the balloon 228, to position the prosthetic valve and the balloon at the desired deployment site within the native valve annulus.
  • One exemplary method for implanting the prosthetic valve 212 in the native aortic valve is as follows.
  • the prosthetic valve 212 initially can be crimped on a mounting region (FIG.5A) of the balloon catheter shaft 226 immediately adjacent the proximal end of the balloon 228 (such as on a crimp balloon).
  • the proximal end of the prosthetic valve can abut the distal end 223 of the guide catheter shaft 222 (FIG.5A), which keeps the prosthetic valve in place on the balloon catheter shaft or crimp balloon as the delivery apparatus and prosthetic valve are inserted through an introducer sheath.
  • the prosthetic valve 212 can be delivered in a transfemoral procedure by first inserting an introducer sheath into the femoral artery and pushing the delivery apparatus through the introducer sheath into the patient’s vasculature.
  • the prosthetic valve 212 can be moved onto the balloon 228.
  • a convenient location for moving the prosthetic valve onto the balloon is the descending aorta.
  • the prosthetic valve can be moved onto the balloon, for example, by holding the handle portion 246 steady (which retains the guide catheter shaft 222 in place) and moving the balloon catheter shaft 226 in the proximal direction relative to the guide catheter shaft 222.
  • the distal end 223 of the guide catheter shaft pushes against the prosthetic valve, allowing the balloon 228 to be moved proximally through the prosthetic valve in order to center the prosthetic valve on the balloon 228.
  • the balloon catheter shaft can include one or more radiopaque markers to assist the user in positioning the prosthetic valve at the desired location on the balloon.
  • the balloon catheter shaft 226 can be moved in the proximal direction by simply sliding/pulling the balloon catheter shaft in the proximal direction if the securement mechanism 298 is not engaged to retain the shaft 226.
  • the securement mechanism 298 can be engaged to retain the shaft 226, in which case the adjustment knob 284 is rotated to effect movement of the shaft 226 and the balloon 228.
  • the axial position of the balloon shaft 226 can be fixed relative to the inner shaft 234, such that axial movement of the balloon shaft 226 relative to the outer shaft 222 produces axial movement of the balloon shaft 226, the inner shaft 234, and the balloon 228 relative to the outer shaft 222.
  • repositioning of the prosthetic valve can be accomplished by moving the outer shaft 222 distally relative to the balloon shaft 226, the inner shaft 234, and the balloon 228.
  • the crimp balloon 225 prior to repositioning the prosthetic valve, can be partially inflated to slightly expand the prosthetic valve, which facilitates sliding of the prosthetic valve relative to the balloon 228.
  • Further details on the delivery apparatus 200 can be found in U.S. Patent No. 9,339,384, which is incorporated by reference herein in its entirety.
  • the tube 229 can be an extension of a proximal leg (or proximal end portion) of the inflation balloon, that has increased rigidity compared to a portion of the inflation balloon that is inflatable when filled with inflation balloon and is used to deploy the prosthetic valve.
  • FIGS.6-47D show examples of various shafts or tubes that can extend between and be used to couple a distal end of a balloon shaft (or balloon catheter shaft, such as balloon catheter shaft 226 of delivery apparatus 200) to a proximal end portion of an inflatable balloon of the delivery apparatus (such as the balloon 228 of the delivery apparatus 200).
  • the tubes or shafts described below can comprise metal, such as stainless steel or Nitinol.
  • the shafts are relatively thin metal tubes (for example, a hypotube) that are cut (for example, laser cut) to form the plurality of openings or cuts (for example, as shown in FIGS.6-27B and 46B-46D).
  • the tubes or shafts comprise a plurality of struts forming various lattice structures (for example, as shown in FIGS.35-44).
  • the tubes or shafts comprise a polymer and/or can be an extension of a proximal leg of the inflatable balloon and have holes or cuts that allow it to bend while also transferrin torque (for example, as shown in FIGS.46A and 48-52B).
  • the tubes or shaft can comprise a polymer and have multiple axially extending lumens, including a central lumen such that the shaft can replace the crimp balloon.
  • the patterns of the cuts or openings in the tubes or shafts described herein can be specified to give the shaft flexibility, in some cases compressibility, and allow for secure attachment to the balloon shaft and the inflation balloon.
  • FIGS.6-12 show a relatively rigid tube or shaft 300 (which can also be referred to herein as a crimp balloon shaft) comprising a plurality of circumferentially extending rows 302 of cuts that are spaced axially apart from one another along a body 305 of the shaft 300.
  • each row 302 of cuts is a continuous cut 304 that extends around a circumference of the shaft 300 and forms a plurality of interconnecting rings 310 (or circumferentially extension sections) with spaced apart projections 306 on both sides of the cut 304 (with notches or spaces 308 defined between adjacent projections), where the projections 306 on opposite sides of the cut 304 alternate with one another such that the projections 306 on the opposite sides of the cut 304 fit together like puzzle pieces with a gap therebetween (the gap formed by a width of the cut 304).
  • the cut pattern of the shaft 300 can be referred to as a “puzzle cut” pattern.
  • each projection 306 on a first side of the cut fits within a space 308 formed between two adjacent projections 306 on a second side of the cut 304, the second side being opposite the first side.
  • the notches or spaces 308 are configured to receive the projections 306 of adjacent circumferentially extending sections 310 (or rings).
  • the notches 308 are sized slightly larger than the projections 306 (that is, the projections 306 are not tightly received within the notches 308), which can allow the shaft 300 to compress axially (in an axial direction defined along a central longitudinal axis of the shaft and delivery apparatus), which is beneficial during inflation of the inflatable balloon (as discussed herein).
  • a width of the cut 304 (or a size of the gap formed between adjacent sections of the shaft 300) can vary based on a desired flexibility of the shaft 300. For example, as the width of the cuts 304 increases, the shaft 300 can compress more axially and/or bend more; however, there may also be more torque delay between the balloon shaft and the inflation balloon.
  • a number of cuts 304, or the spacing between adjacent circumferentially extending cuts 304 can also vary based on a desired flexibility of the shaft 300. For example, a smaller spacing between adjacent cuts 304, can result in more cuts 304 and smoother bending of the shaft 300. In contrast, larger spaces between the cuts 304 can result in greater overall bendability of the shaft 300.
  • the projections 306 can be received within the notches 308 without any clearance or space between the adjacent surfaces of the projections and the notches.
  • the shaft 300 comprises metal, such as stainless steel.
  • FIG.6 shows an exemplary delivery apparatus 320 including the shaft 300 coupled between the balloon shaft 326 and the inflation balloon 328 (which may also be referred to herein as an “inflatable balloon”).
  • the delivery apparatus 320 can be the same or similar to the delivery apparatus 200, as described above, except for the inclusion of the shaft 300 underneath or over the crimp balloon 330.
  • the delivery apparatus 320 comprises a balloon shaft 326 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 320 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis 322 of the delivery apparatus 320.
  • the delivery apparatus further comprises an inner shaft 334 extending through the balloon shaft 326 to a polymeric body mounted on the distal end of the inner shaft 334.
  • the polymeric body can be a distal shoulder 336 and nose cone 332, as shown in FIG.6.
  • the distal shoulder 336 and nose cone 332 can be formed (for example, molded together) as one piece.
  • the crimp balloon 330 extends over (and surrounds) the shaft 300 and extends distally from the balloon shaft 326 to the inflation balloon 328. Further, the shaft 300 extends over a portion of the inner shaft 334 (the portion extending past the distal end of the balloon shaft 326 and the proximal end of the inflation balloon 328). [0277] In some examples, a first end (or proximal end) of the shaft 300 comprises a first attachment interface 312 and an opposite, second end (or distal end) of the shaft 300 comprises a second attachment interface 314. The first attachment interface 312 is configured to couple to the distal end of the balloon shaft 326, as shown in FIGS.10 and 12.
  • the second attachment interface 314 is configured to couple to a proximal end portion, which may include proximal legs in some examples, of the inflation balloon 328, as shown in FIGS. 11A and 11B.
  • the first attachment interface 312 comprises a plurality of proximal struts 316 that are spaced apart around the first end and of the shaft 300 (as shown in FIGS.9, 10, and 12). Each proximal strut 316 can flare outward from the body of the shaft 300 and spiral along the distal end of the balloon shaft (as shown in FIGS.10 and 12). Each proximal strut 316 can be clamped onto an outer surface of the distal end of the balloon shaft 326, as shown in FIG.12.
  • the proximal struts 316 are secured or bonded to the outer surface of the distal end of the balloon shaft 326 by reflowing a polymer over the struts 316 and the distal end of the balloon shaft 326. [0280] In some examples, the proximal struts 316 are secured or bonded to the outer surface of the distal end of the balloon shaft 326 by an adhesive, tape, welding, or other fasteners. [0281] In some examples, each proximal strut 316 includes an aperture 317 in its proximal end that connects to the body 305 of the shaft 300, as shown in FIG.8.
  • the aperture 317 is configured to provide strain relief to the proximal strut 316.
  • the aperture 317 looks like a star with four or more slits extending from the central opening of the aperture 317.
  • Additional examples of a first attachment interface for the shaft 300 or the other shafts described herein is shown in FIGS.26, 27A, 30, 32, 33, and 34 (as described further below), any of which can replace the first attachment interface 312.
  • the second attachment interface 314 comprises a plurality of axially extending struts 318 that are spaced circumferentially apart around the second end.
  • each axially extending strut 318 has an arrow-shaped head 319 (or tip) or other flared end portion at its distal end (as shown in FIG.9).
  • the proximal end portion or legs of the inflation balloon 328 comprises a plurality of holes 338.
  • Each arrow-shaped head 319 (or flared end portion) of each axially extending strut 318 can be inserted into a respective hole 338 to couple the second end of the shaft 300 to the proximal end portion of the inflation balloon 328 (as shown in FIG.11A).
  • each strut 318 includes an aperture 321 in its proximal end that connects to the body 305 of the shaft 300.
  • the aperture 321 is configured to provide strain relief to the strut 318.
  • the apertures 321 can have various shapes, such as diamond-shaped (as shown in FIG.8), square, star-shaped, circular, triangular, or the like.
  • the diamond-shaped apertures 321 can allow the second attachment interface 314 to form a continuous ring shape for better mating with the proximal leg of the inflation balloon 328.
  • FIGS.28, 29, 31, 79A-82B, and 83B Additional examples of a second attachment interface for the shaft 300 or the other shafts described herein is shown in FIGS.28, 29, 31, 79A-82B, and 83B (as described further below), any of which can replace the second attachment interface 314.
  • FIG.11B the proximal end portion of the inflation balloon 328 (which may include legs 340) and the second end of the shaft 300 are bonded together by a polymer reflowed over the arrow-shaped heads 319 of the struts 318 coupled to the holes 338 of the inflation balloon 328.
  • the polymer is also reflowed over the crimp balloon 330, as shown in FIG.11B, thereby securely bonding the proximal end portion of the inflation balloon 328, the distal end of the crimp balloon 330, and the second (or distal) end of the shaft 300 together.
  • a fluid seal can be created such that inflation fluid passing through a space between an outer surface of the inner shaft 334 and the inner surface of the crimp balloon 330 is fluidly connected to an interior of the inflation balloon 328.
  • Other techniques and/or mechanisms can be used to secure the balloon 328 to the second attachment interface 314, such as an adhesive, welding, tape, and/or mechanical fasteners.
  • FIG.13 depicts the delivery apparatus 320 including a shaft 350 that is similar to the shaft 300 described above (for example, it has the same body 305). However, in the example of FIG.13, the shaft 350 is longer and extends over the inner shaft 334 and through the inflation balloon 328, to a distal end of the delivery apparatus 320. In some examples, as shown in FIG.13, the shaft 350 extends all the way to the distal shoulder 336 of the delivery apparatus 320. It should be noted that although a covering element or sleeve 335 (such as a polymer or tape) is covering the distal end of the shaft 350 in FIG.13, the distal end of the shaft 300 can extend all the way to the proximal end of the distal shoulder 336.
  • a covering element or sleeve 335 such as a polymer or tape
  • FIG.15 shows the shaft 400 with a first type of attachment interface at its distal end
  • FIG.16 shows a flattened view of the entire shaft 400 having a second type of attachment interface at its distal end and another attachment interface at its proximal end
  • FIG.17 shows a more detailed view of the shaft 400 at its attachment interfaces coupling to the balloon shaft and inflation balloon of the delivery apparatus 420.
  • each row 402 of cuts comprises a plurality of individual cuts 404 that are spaced circumferentially apart around the shaft 400.
  • Each individual cut 404 is a circumferential cut (extending in the circumferential direction and arranged perpendicular to a central longitudinal axis of the shaft 400.
  • FIG.69 depicts another example of diamond-shaped cuts for any of the metal tubes or shafts described herein, as described further below.
  • the cuts 404 in the shaft 400 can be replaced by any of the cuts shown in FIGS.19-25 or 69.
  • FIG.19 shows an example of cuts 450 that comprise an elongate body without wider end portions (for example, the cuts 450 do not have the wider end portions 406).
  • FIG.20 shows an example of cuts 452 that also do not have wider end portions, but the cuts 452 are arranged at a non-zero angle relative to the circumferential direction. As such, the cuts 450 are spiral interrupted cuts. This arrangement of cuts 452 may help to prevent shearing of the shaft during rotation.
  • FIG.24 shows an example of cuts 468 having additional triangular cuts 470 disposed along their body 472.
  • the triangular cuts 470 extend outward from the body 472 at a location along the body 472 that is spaced apart from the wider end portions 474. This configuration may further increase the flexibility of that shaft.
  • FIG.25 shows an example of cuts 476 having a body 478 that is wider than its end portions 480. For example, as shown in FIG.25, the body 478 narrows to the circular end portions 480 of the cuts 476.
  • the shaft 400 can be included within a delivery apparatus, such as the exemplary delivery apparatus 420 shown in FIGS.14 and 17.
  • the first attachment interface 412 is configured to couple to the distal end of the balloon shaft 426, as shown in FIG.17.
  • the second attachment interface 414 is configured to couple to a proximal end, or proximal leg, of the inflation balloon 428, as shown in FIG.17.
  • the first attachment interface 412 comprises a plurality of proximal struts 416 that are spaced apart around the first end and of the shaft 300 (as shown in FIGS. 16 and 17).
  • the proximal struts 416 can be the same as the proximal struts 316 of shaft 300, as described above.
  • each proximal strut 416 can flare outward from the body 405 of the shaft 400 and spiral along and clamp to the distal end of the balloon shaft 426 (as shown in FIG.17).
  • FIGS.26, 27A, 30, 32, 33, 34, 71-77B, and 78B are shown in FIGS.26, 27A, 30, 32, 33, 34, 71-77B, and 78B (as described further below).
  • the struts 416 or other features of first attachment interface 412 can be fixed to the shaft 426 by any of the various techniques or mechanisms described above with respect to the shaft 300.
  • the second attachment interface 414 comprises a plurality of axially extending struts 418 that are spaced circumferentially apart around the second end, as shown in FIG.15.
  • the axially extending struts can be the same or similar to the axially extending struts 318, as described above, and can be fixed to the balloon 428 using any of the various techniques or mechanisms described above with respect to the shaft 300.
  • the shaft 400 has a different second attachment interface 414 comprising a plurality of distal struts 423 that are spaced apart around the second end and of the shaft 400.
  • Each distal strut 423 can flare outward from the body of the shaft 400 and spiral along the proximal leg of the inflation balloon 428, as shown in FIG.17.
  • one or more, or each of, the distal struts 423 can comprise one or more apertures 422 in their flared, free ends, as shown in FIG.16. This can enable better bonding of the shaft 400 to the inflation balloon when a polymer is reflowed over this connection interface, as described below (for example, the polymer can flow through the apertures 422 and bond to the material of the proximal end of the inflation balloon 428).
  • a fluid seal can be created such that inflation fluid passing through a space between an outer surface of the inner shaft 434 and the inner surface of the crimp balloon 430 is fluidly connected to an interior of the inflation balloon 428.
  • the shaft 400 is incompressible in the axial direction, thereby resulting in decreased delay in torque transfer. As a result, torque from the balloon shaft 426 can be more quickly transferred to the distal end of the shaft 400.
  • due to its incompressibility in the axial direction it may not be desirable to size the shaft 400 such that it extends within the inflation balloon 428.
  • a shaft 500 can combine features of the shafts 300 and 400 to allow for axial compression within the balloon, but decreased torque delay for better torque transfer along a prosthetic valve mounting region of the shaft 500.
  • FIG.18 shows the exemplary shaft 500 that comprises a first section 502 comprising the cuts 404 and a second section 504 comprising the cuts 304.
  • the first section 502 can extend from the balloon shaft to the proximal end of the inflation balloon and the second section 504 can extend from the proximal end of the inflation balloon to a distal end of the delivery apparatus (such as to the distal shoulder).
  • the body 602 comprises the same cuts 404 as the shaft 400 (as described above with reference to FIGS.14-17). However, it is possible for the body 602 to have any arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25). Further, one or more of the attachment interfaces (or end portions) of any of the shafts described here can be replaced by the first and/or second attachment interfaces 612, 614. [0330]
  • the first attachment interface 612 and the second attachment interface 614 are tubular (annular) and they each comprise a plurality of cut-outs or openings 604.
  • the openings 604 allow for the formation of a stronger bond between the first and second attachment interfaces 612, 614 and the balloon shaft and inflation balloon, respectively.
  • the first and second attachment interfaces 624 and 626 of FIGS. 27A-27B as described below, can be arranged over the first and second attachment interfaces 612 and 614, respectively, in shaft 600 and a polymer can reflow through the openings 604 into the first and second attachment interfaces 624 and 626 (which, in some examples, can be polymeric transition parts).
  • the openings 604 are spaced apart around and along each of the first attachment interface 612 and the second attachment interface 614.
  • the openings 604 can be diamond-shaped and form a repeating pattern along and around the first attachment interface 612 and the second attachment interface 614. [0335] In some examples, the openings 604 can have a different shape, such as circular, square, oblong, triangular, or the like. [0336] In some examples, each of the first attachment interface 612 and the second attachment interface 614 can have a first section 606 without any openings 604 disposed between the respective attachment interface and the body 602.
  • FIGS.27A and 27B show an exemplary shaft 620 comprising a body 622 extending between a first attachment interface 624 (or proximal end portion) and a second attachment interface 626 (or distal end portion).
  • the body 622 comprises metal (such as stainless steel).
  • the body 622 comprises the same cuts 404 as the shaft 400 (as described above with reference to FIGS.14-17).
  • the body 622 it is possible for the body 622 to have any arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25).
  • the second attachment interface 626 tapers from the larger outer diameter of the proximal end portion of the inflation balloon 428 to the smaller outer diameter of the body 622 of the shaft 620.
  • the first and second attachment interfaces 624, 626 comprising a softer polymer (rather than a rigid metal), they can provide strain relief at the connections between the shaft 600 and the balloon shaft and inflation balloon.
  • first attachment interface 624 and/or the second attachment interface 626 can comprise slots, holes, or the like in their tapered portions, thereby providing a path for fluid to flow therethrough.
  • first attachment interface 624 and the second attachment interface 626 can be arranged over the first and second attachment interfaces 612, 614, respectively, in shaft 600.
  • the attachment interfaces 624, 626 can be referred to as first and second outer attachment interfaces
  • the attachment interfaces 612, 614 can be referred to as first and second inner attachment interfaces with the outer attachment interfaces extending coaxially over respective inner attachment interfaces.
  • FIG.29 shows an exemplary attachment interface 640 for any of the crimp balloon shafts described herein.
  • the attachment interface 640 can be a distal attachment interface that is configured to couple to an outer surface of and/or holes in a proximal end of the inflation balloon of the delivery apparatus (similar to as shown in FIGS. 11A-11B and 17).
  • the attachment interface 640 comprises a plurality of struts 642 that are spaced circumferentially apart around the interface. Each strut 642 has a curved or hooked end portion 644 at its distal end.
  • the struts 642 can be similar to struts 632, except they have a hooked shape that flares outward and has a greater length.
  • each strut 652 can flare outward from the body of the shaft and spiral along the distal end of the balloon shaft (for example as shown in FIGS.10, 12, and 16). In some examples, each strut 652 clamps to an outer surface of the distal end of the balloon shaft. [0358] In some examples, each strut 652 extends from a lattice structure of the attachment interface 650.
  • the lattice structure can comprise a plurality of spaced apart and repeating openings 654. These openings can provide a fluid path for a polymer reflowed over the attachment interface 650 (and the distal end of the balloon shaft).
  • the lattice structure defined by the struts 652 can be configured to flare, or radially expand and compress, like a stent.
  • the lattice structure can vary and have openings with different sizes, shapes, and/or arrangement than that shown in FIG.30.
  • FIG.31 shows an exemplary attachment interface 660 for any of the crimp balloon shafts described herein.
  • the attachment interface 660 can be a distal attachment interface that is configured to couple to an outer surface of and/or holes in a proximal end of the inflation balloon of the delivery apparatus (similar to as shown in FIGS.11A-11B and 17).
  • FIG.32 shows an exemplary attachment interface 670 for any of the crimp balloon shafts described herein.
  • the attachment interface 670 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface.
  • the attachment interface 670 comprises a plurality of struts 672 (for example, two, three, or the like) that are spaced circumferentially apart around the interface.
  • Each strut 672 can comprise a leg 674 and a distal end 676 having a relatively large opening 678 (for example, the opening 678 can be at least three times larger or wider than a width of the material or strut at the distal end that forms the opening 678). In some examples, the width of the distal end 676 is wider than a width of the leg 674 where it connects to the distal end 676.
  • the struts 672 can be configured to clamp around an outer surface of the distal end of the balloon shaft.
  • the relatively wide openings 678 are configured to receive a reflowed polymer therethrough, thereby providing enhanced bonding between the balloon shaft and the attachment interface 670.
  • each strut 682 can comprise a leg 684 and a distal end 686 having a relatively large opening 688 (for example, the opening 688 can be at least three times larger or wider than a width of the material or strut at the distal end that forms the opening 688). In some examples, the width of the distal end 686 is wider than a width of the leg 684 where it connects to the distal end 686.
  • the struts 682 can be configured to clamp around an outer surface of the distal end of the balloon shaft.
  • the relatively wide openings 688 are configured to receive a reflowed polymer therethrough, thereby providing enhanced bonding between the balloon shaft and the attachment interface 680.
  • the legs 684 can have a different shape (for example, wider along most of their length) and the openings 688 in the distal ends 686 can be slightly narrower. In some examples, the wider legs 684 can hold the flare better (flare outward from the body of the shaft) and be stronger and more resistant to deformation under torque (when attached to the balloon shaft).
  • FIG.34 shows an exemplary attachment interface 690 for any of the crimp balloon shafts described herein.
  • the attachment interface 690 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface.
  • the attachment interface 690 is tubular and comprises a proximal end portion 692 that is configured to be coupled to the balloon shaft of the delivery apparatus, a distal end portion 694 that is configured to be coupled (such as via welding) to the crimp balloon shaft (the body), and an intermediate portion 696 that tapers from the proximal end portion 692 to the distal end portion 694.
  • the proximal end portion 692 has a larger diameter than the distal end portion 694, and thus the intermediate portion 696 tapers and transitions radially inward from the proximal end portion 692 to the distal end portion 694.
  • the diameter of the proximal end portion 692 can be sized to fit around the distal end of the balloon shaft and the diameter of the distal end portion 694 can be sized to fit against and be bonded to an outer surface of the body of the crimp balloon shaft (such as body 305 or 405).
  • the distal end portion 694 is welded (for example, laser welded) to the body of the crimp balloon shaft.
  • the proximal end portion 692 can include a plurality of spaced apart openings 698 that provide a fluid path for a polymer that is reflowed over the proximal end portion 692 mounted around a balloon shaft, thereby bonding the overlapping parts together.
  • the openings 698 are depicted in FIG.34 as rectangular, the openings 698 can have various shapes and/or sizes, such as oblong, square, trapezoidal, or the like.
  • the intermediate portion 696 can include a plurality of spaced apart openings 699 for receiving the reflowed polymer therethrough.
  • the shaft 1700 can comprise metal, such as stainless steel (for example, the shaft 1700 may be a hypotube), with opposing end portions defining first and second attachment interfaces 1712, 1714 and a main body 1702 extending between the first and second attachment interfaces 1712, 1714.
  • the shaft 1700 can be included in a delivery apparatus, such as any of the delivery apparatuses described herein, and extend from a balloon shaft of the delivery apparatus (for example, balloon shaft 426 shown in FIG.14 or the balloon shaft 226 shown in FIG.5B) to an inflation balloon of the delivery apparatus (for example, inflation balloon 428 shown in FIG.14 or the inflation balloon 228 shown in FIG.5B).
  • a balloon shaft of the delivery apparatus for example, balloon shaft 426 shown in FIG.14 or the balloon shaft 226 shown in FIG.5B
  • an inflation balloon of the delivery apparatus for example, inflation balloon 428 shown in FIG.14 or the inflation balloon 228 shown in FIG.5B.
  • the shaft 1700 can be used in lieu of the shaft 400 in the delivery apparatus 420.
  • the body 1702 comprises a plurality of cuts 1704 (for example, diamond shaped cuts as shown) (which may be the same or similar to the cuts 1610 shown in FIG.69).
  • the cuts 1704 can be arranged into a plurality of circumferentially extending rows of cuts 1704, where the rows are spaced axially apart along the body 1702 of the shaft 1700, relative to a central longitudinal axis 1706 of the shaft 1700. Each row comprises a plurality of individual cuts 1704 that are spaced circumferentially apart around the shaft 1700.
  • each diamond shaped cut 1704 extends in the circumferential direction.
  • the cuts 1704 extend through an entire thickness of the shaft 1700 (that is, a wall of the shaft 1700), thereby forming openings in the shaft.
  • the cuts 1704 in adjacent rows are staggered such that an individual cut 1704 in a first row is circumferentially offset from the closest neighboring cuts 1704 in a second row that is adjacent to the first row.
  • the staggering of cuts 1704 in adjacent rows can mimic an interrupted spiral, thereby increasing the torsional strength of the shaft 1700.
  • the body 1702 it is possible for the body 1702 to have any of the arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25 or 69). Further, one or more of the attachment interfaces (or end portions) of any of the shafts described here can be replaced by the first and/or second attachment interfaces 1712, 1714. [0387] As described herein, a diameter of the body 1702 can be minimized to reduce a crimp profile of a prosthetic device mounted thereon, while still allowing an inner shaft of the delivery apparatus to pass therethrough with clearance therebetween.
  • the first attachment interface 1712 is configured to be coupled to a distal end of the balloon shaft (for example, the balloon shaft 426, similar to as shown in FIG.17).
  • the second attachment interface 1714 is configured to be coupled to a proximal end portion (or proximal leg) of the inflation balloon (for example, the inflation balloon 428, similar to as shown in FIG.17).
  • the first attachment interface 1712 and the second attachment interface 1714 comprise lattice structures that are configured to radially expand to different sizes (and radially compress to a less radially expanded or at least partially radially collapsed configuration when being coupled to a balloon leg or balloon shaft).
  • the lattice structures can comprise one or more circumferentially extending rows of cells (which can also be referred to as openings) arranged end-to-end around the first attachment interface 1712 and the second attachment interface 1714.
  • the cells or openings allow for fluid transfer, such as a polymer passing therethrough during reflowing or bonding a balloon or other polymeric layer thereto.
  • the lattice structure of cells allows the first attachment interface 1712 and the second attachment interface 1714 to radially expand from a radially collapsed configuration (e.g., as shown in FIG.72A) to a radially expanded configuration (e.g., as shown in FIG. 72B).
  • FIGS.71-72B depict the second attachment interface 1714 in a flattened (non-cylindrical) configuration (FIG.71), a radially collapsed configuration (FIG.72A), and a radially expanded configuration (FIG.72B).
  • the lattice structure of the second attachment interface 1714 can comprise at least a first circumferentially extending row of first cells 1720 disposed at the free end 1718 of the second attachment interface 1714.
  • the first cells 1720 have an elongated convex hexagon shape (as compared to a length of the cells in adjacent rows, where the length is defined in the axial direction) and form apices 1721 defining the free end 1718.
  • the lattice structure of the second attachment interface 1714 optionally can comprises a second circumferentially extending row of second cells 1722 disposed adjacent to the first cells 1720, a third circumferentially extending row of third cells 1724 disposed adjacent to the second cells 1722, a fourth circumferentially extending row of fourth cells 1726 disposed adjacent to the third cells 1724, and/or a fifth circumferentially extending row of fifth cells 1728 disposed adjacent to the fourth cells 1726.
  • the second cells 1722, third cells 1724, fourth cells 1726, and fifth cells 1728 can have a diamond shape, as shown in FIGS.71-72B [0395] As the second attachment interface 1714 is radially expanded at its free end 1718, or flared radially outward, the cells of the lattice structure widen (in the circumferential direction), with a width 1717 of the first cells 1720 increasing the most, as compared the cells in adjacent rows, as shown in FIG.72B. As a result, the second attachment interface 1714 can more easily fit around the inflation balloon and be bonded thereto.
  • FIGS.73A-73D depict an exemplary process for manufacturing the shaft 1700, and similar tubes for a delivery apparatus, and flaring and bonding the second attachment interface 1714 to an inflation balloon 428.
  • the process begins by cutting (e.g., laser cutting) or otherwise forming the cuts 1704 (or any of the other cuts described herein) and the cells of the first and second attachment interfaces 1712, 1714 (which may be any of the attachment interfaces described herein) into a tube 1710 (e.g., a metal tube or hypotube).
  • a tube 1710 e.g., a metal tube or hypotube
  • the second attachment interface 1714 has a more simplified lattice structure with fewer circumferentially extending rows of cells, for ease of illustration.
  • the second attachment interface 1714 can be in its radially collapsed or non-flared configuration after the cutting/forming step.
  • the second attachment interface 1714 can then be flared radially outward using a flaring tool which results in the flared configuration shown in FIG.73C. In this configuration, the second attachment interface 1714 increases in diameter from the body 1702 to its free end 1718.
  • the first cells 1720 widen and the second attachment interface 1714 can fit around a proximal leg of the inflation balloon 428.
  • the second attachment interface 1714 can be radially compressed around and bonded to the inflation balloon 428, as shown in FIG.73C.
  • a radial compression bonding apparatus can apply radially inward pressure and heat to the second attachment interface 1714 arranged around the proximal leg of the inflation balloon 428 in order to bond the second attachment interface 1714 to the inflation balloon 428.
  • a crimp balloon 430 can be positioned over the shaft 1700 and a portion of the second attachment interface 1714, as shown in FIG.73D.
  • FIGS.74A and 74B depict a flattened (non-cylindrical) view (FIG.74A) and a flared or radially expanded view (FIG.74B) of an attachment interface 1760 with a lattice structure comprising a plurality of circumferentially extending rows of cells that are arrayed from a free end 1762 of the attachment interface 1760 to the body of the shaft (e.g., the body 1702 of the shaft 1700).
  • the attachment interface 1760 comprises a first row of first cells 1764, a second row of second cells 1765, a third row of third cells 1766, a fourth row of fourth cells 1767, a fifth row of fifth cells 1768, and a sixth row of sixth cells 1769, all cells of which are diamond shaped.
  • the first cells 1764 and second cells 1765 are the largest and the cells in the other rows decrease in size from the second row to the sixth row. This configuration results in an attachment interface 1760 with an increased number of cells (compared to other attachment interfaces described herein), which allows for more even polymer mating to the inflation balloon and crimp balloon.
  • the attachment interface 1770 comprises a first row of first cells 1774, a second row of second cells 1775, a third row of third cells 1776, a fourth row of fourth cells 1777, and a fifth row of fifth cells 1778, all cells of which have an elongated diamond shape.
  • the attachment interface 1770 also comprises a sixth row of sixth cells 1779 that have an irregular diamond shape with pairs of adjacent sixth cells 1779 angling toward each other.
  • the attachment interface 1770 also comprises a seventh row of seventh cells 1772 that have a curved wedge shape.
  • This configuration of cells provides a longer tapered ramp (when the attachment interface 1770 is in the flared configuration, as shown in FIG.75B) from the body of the shaft to the proximal leg of the inflation balloon, which improves valve alignment and movement when a prosthetic valve is moved from a position around the crimp balloon to a position around the inflation balloon.
  • FIGS.76A and 76B depict a flattened (non-cylindrical) view (FIG.76A) and a flared or radially expanded view (FIG.76B) of an attachment interface 1780 with a lattice structure comprising a first circumferentially extending row of first cells 1784, a second circumferentially extending row of second cells 1786 disposed adjacent to the first cells 1784, and a third circumferentially extending row of third cells 1788 disposed adjacent to the second cells 1786.
  • Apices 1782 of the first cells 1784 define a free end of the attachment interface 1780.
  • the first cells 1784 have an elongated convex hexagon shape with thicker axially extending sides 1785 that are shared between adjacent first cells 1784.
  • the first cells 1784 also comprise curved cutouts 1783 at edge junctions of the first cells 1784.
  • the cutouts 1783 allow the first cells 1784 to be radially compressed down after flaring, such as when the attachment interface 1780 is radially compressed and bonded to the proximal leg of the inflation balloon.
  • the second cells 1786 and third cells 1788 have a diamond shape.
  • FIG.77A and 77B depict a flattened (non- cylindrical) view (FIG.77A) and a flared or radially expanded view (FIG.77B) of the first attachment interface 1712 with a lattice structure comprising at least a first circumferentially extending row of first cells 1730, which in some examples have an elongated convex hexagonal shape as shown.
  • each first cell 1730 can be split into an outer cell 1732 (having a diamond shape) at the free end 1716 of the first attachment interface 1712, a first inner cell 1734 (having a chevron shape), and a second inner cell 1736 (having a chevron shape), wherein the first inner cell 1734 is formed by a first V-shaped strut 1738 and a second V-shaped strut 1740 that span a width of the first cell 1730.
  • the first V-shaped strut 1738 and second V-shaped strut 1740 are spaced axially apart within the first cell 1730 by axial struts 1733.
  • the first inner cells 1734 and second inner cells 1736 are configured to allow for easier insertion into a pocket or cavity in the balloon shaft (such as the cavity 1904 of the balloon shaft 1926, as shown in FIG.84, which is described in greater detail below) while also maintaining anchoring to the balloon shaft.
  • the struts defining the first cells 1730 including the first V-shaped strut 1738 and the second V-shaped strut 1740, have cut-outs or notches 1748 disposed at the ends of the first V-shaped strut 1738 and the second V-shaped strut 1740.
  • the lattice structure optionally can further comprise one or more additional rows of cells, such as a second circumferentially extending row of diamond shaped second cells 1742, a third circumferentially extending row of diamond shaped third cells 1744, and/or a fourth circumferentially extending row of diamond shaped fourth cells 1746.
  • the fourth cells 1746 are smaller than the third cells 1744, and the third cells 1744 are smaller than the second cells 1742.
  • the first attachment interface 1712 As the first attachment interface 1712 is radially expanded at its free end 1716, or flared radially outward, the cells of the lattice structure widen (in the circumferential direction), with a width of the first cells 1730 increasing the most, as compared the cells in adjacent rows, as shown in FIG.77B. As a result, the first attachment interface 1712 can more easily fit around the balloon shaft and be bonded thereto.
  • the process begins by cutting (e.g., laser cutting) or otherwise forming the cuts 1704 (or any of the other cuts described herein) and the cells of the first and second attachment interfaces 1712, 1714 (which may be any of the attachment interfaces described herein) into a tube 1710 (e.g., a metal tube or hypotube).
  • a tube 1710 e.g., a metal tube or hypotube.
  • the shaft 1700 shown in FIG.78B (which may be the same as the shaft 1700 shown in FIG. 70).
  • the first attachment interface 1712 is in its radially collapsed or non-flared configuration or state.
  • the first attachment interface 1712 can then be flared radially outward using a flaring tool which results in the flared configuration shown in FIG.78C.
  • the first attachment interface 1712 increases in diameter from the body 1702 to its free end 1716.
  • the first cells 1730 widen (as best seen in FIG.77B) and the first attachment interface 1712 can fit around and/or within a distal end portion of the balloon shaft (e.g., balloon shaft 426 or balloon shaft 1926 shown in FIG.84).
  • the first attachment interface 1712 is then bonded to the balloon shaft, as shown in FIG.78C.
  • the amount of flare (or size of the step) of the flared end 1910 may be exaggerated in FIG.84 for the purpose of illustration only.
  • the distal end portion of the second braided layer 1908 is shown as forming a sharp step relative to a proximal portion of the second braided layer 1908.
  • the second braided layer 1908 can form a smooth or gradual flared transition section extending from the proximal portion to the distal portion at location of the pocket.
  • a space or cavity 1904 is formed between the first braided layer 1906, which can comprise a metal braid, and the second braided layer 1908, which can comprise a metal braid.
  • a polymer layer (e.g., formed from PEBAX) can extend co-axially between the first braided layer 1906 and the second braided layer 1908.
  • an inner polymer layer (e.g., formed from PEBX) can extend co-axially through and cover an inner surface of the first braided layer 1906.
  • the balloon shaft 1926 can further comprise an outer polymeric layer 1916 (or jacket) surrounding the second braided layer 1908. The polymer layers can be reflowed such that the first and second braided layers 1906, 1908 become embedded within the polymer layers.
  • first braided layer 1906 and the second braided layer 1908 may not include a metal braid, or the metal braid may not extend into or all the way through the distal end portion 1902.
  • the flared first attachment interface 1712 can be inserted into the cavity 1904, as shown in FIG.84, and then radially compressed around the first braided layer 1906.
  • the first attachment interface 1712 is then bonded (e.g., split die bonded) to the balloon shaft 1926, within the cavity 1904.
  • the distal end portion 1902 of the balloon shaft 1926 can be inserted into a bonding apparatus that applies radially inward pressure (i.e., compression) and heat to the assembled distal end portion 1902 and first attachment interface 1712.
  • a bonding apparatus that applies radially inward pressure (i.e., compression) and heat to the assembled distal end portion 1902 and first attachment interface 1712.
  • polymer from the first braided layer 1906 and/or the second braided layer 1908 can flow through the cells (e.g., cells 1732, 1734, and 1736) in the first attachment interface 1712, thereby bonding the first attachment interface 1712 and the distal end portion 1902 to each other, as shown in FIG.78D.
  • the flared first attachment interface 1712 can be fit over and radially compressed around a distal end portion of a balloon shaft (such as balloon shaft 426 or any of the other balloon shafts described herein) and then bonded to the balloon shaft (for example, by reflowing a polymer around the first attachment interface 1712 and the outer polymeric layer or jacket of the balloon shaft).
  • the crimp balloon 430 can then be bonded thereto, as described above.
  • FIGS.79-83B depict examples of different attachment interfaces comprising a lattice structure, which can be used in lieu of the first attachment interface 1712 in the shaft 1700 or similar shafts.
  • FIG.79 depicts a flattened (non-cylindrical) view of an attachment interface 1800 with a lattice structure comprising a first circumferentially extending row of first cells 1804, a second circumferentially extending row of second cells 1806 disposed adjacent to the first cells 1804, and a third circumferentially extending row of third cells 1808 disposed adjacent to the second cells 1806.
  • Apices 1802 of the first cells 1804 define a free end of the attachment interface 1800.
  • the first cells 1804 have an elongated convex hexagon shape, while the second cells 1806 and third cells 1808 have a tapered diamond shape.
  • This lattice structure can be referred to as a “tapered lattice” and can provide more even stress distribution across the attachment interface 1800.
  • FIG.80 depicts a flattened (non-cylindrical) view of an attachment interface 1810 with a lattice structure comprising a first circumferentially extending row of first cells 1814, a second circumferentially extending row of second cells 1816 disposed adjacent to the first cells 1814, and a third circumferentially extending row of third cells 1818 disposed adjacent to the second cells 1816.
  • FIGS.81A and 81B depict a flattened (non-cylindrical) view (FIG.81A) and a flared or radially expanded view (FIG.81B) of an attachment interface 1820 with a lattice structure comprising a first circumferentially extending row of first cells 1824, a second circumferentially extending row of second cells 1826 disposed adjacent to the first cells 1824, and a third circumferentially extending row of third cells 1828 disposed adjacent to the second cells 1826, and a fourth circumferentially extending row of fourth cells 1830 disposed adjacent to the third cells 1828.
  • Apices 1822 of the first cells 1824 define a free end of the attachment interface 1820.
  • the first cells 1824, second cells 1826, and third cells 1828 have a hexagonal-like shape with curved or rounded axially opposing ends.
  • the fourth cells 1830 have a diamond-like shape with a wider base at the end disposed opposite the third cells 1828. The shape of the fourth cells 1830 allows for maximum fluid flow therethrough and the shape of the first cells 1824 allows for easier flaring when expanded to the flared configuration shown in FIG.81B.
  • FIGS.82A and 82B depict a flattened (non-cylindrical) view (FIG.82A) and a flared or radially expanded view (FIG.82B) of an attachment interface 1840 with a lattice structure comprising a first circumferentially extending row of first cells 1844, a second circumferentially extending row of second cells 1846 disposed adjacent to the first cells 1844, a third circumferentially extending row of third cells 1848 disposed adjacent to the second cells 1846, and a fourth circumferentially extending row of fourth cells 1849 disposed adjacent to the third cells 1848.
  • Apices 1842 of the first cells 1844 define a free end of the attachment interface 1840.
  • FIGS.83A and 83B depict a flattened (non-cylindrical) view (FIG.83A) and a flared or radially expanded view (FIG.83B) of an attachment interface 1850 with a lattice structure comprising a first row of first cells 1852, a second row of second cells 1853, a third row of third cells 1854, a fourth row of fourth cells 1855, and a fifth row of fifth cells 1856.
  • the first cells 1852, second cells 1853, and third cells 1854 all have an elongated diamond shape. In some examples, as shown in FIGS.83A and 83B, the first cells 1852, second cells 1853, and third cells 1854 are all the same size, or at least substantially the same size.
  • the fourth cells 1855 have an irregular diamond shape with pairs of adjacent fourth cells 1855 angling toward each other.
  • the fifth cells 1856 have a curved wedge-like shape.
  • the fourth cells 1855 and fifth cells 1856 define a transition zone 1857 of the attachment interface 1850 that transitions from the body of the shaft and the flared free end 1858 of the attachment interface 1850, as shown in FIG.83B. This provides increased strength to the attachment interface 1850 in the flared state.
  • the shaft 700 can extend from the distal end of the balloon shaft at least to the proximal end of the inflation balloon in a delivery apparatus, such as the delivery apparatus 200, 320, or 420.
  • a delivery apparatus such as the delivery apparatus 200, 320, or 420.
  • the shaft 700 can be used in lieu of the shaft 300 in the delivery apparatus 320 shown in FIG.6.
  • the shaft 700 can extend from the distal end of the balloon shaft to the distal shoulder of the delivery apparatus, such as the delivery apparatus 200, 320, or 420.
  • the shaft 700 can be used in lieu of the shaft 300 in the delivery apparatus 320 shown in FIG.13.
  • the shaft 700 is radially compressible and bendable.
  • the shaft 700 comprises alternating sections that are configured to compress radially (provided by first sections 706 of the shaft 700) and flex or bend about a central longitudinal axis of the shaft 700 (provided by second sections 708 of the shaft 700).
  • the shaft 700 can comprise one or more first sections 706 (three are shown in FIGS.35 and 37) and one or more second sections 708 (two are shown in FIGS. 35 and 37) which alternate with each other along the length of the shaft.
  • each second section 708 is arranged between two adjacent first sections 706.
  • the shaft 700 can comprise more or less first sections 706 and/or second sections 708 than those shown in FIGS.35 and 37.
  • the shaft 700 can comprises two first sections 706 and one second section 708 or four first sections 706 and three second sections 708.
  • FIG.36 shows an enlarged view of a portion of the shaft 700 in a flattened configuration.
  • Each first section 706 comprises struts 702 that form a first diamond lattice structure with diamond-shaped first cells 712 having a long dimension oriented in the axial direction.
  • Each second section 708 comprises struts 702 that form a second diamond lattice structure with diamond-shaped second cells 714 having a long dimension oriented in the circumferential direction.
  • the struts 702 of the first and second sections 706, 708 are directly connected to one another, such that the first and second sections 706, 708 are interconnected along the shaft 700.
  • the shaft 700 can comprise axially extending struts 716 and Y-shaped struts 718 (which can collectively be referred to herein as connecting struts) that extend between strut junctions at an end of a first section 706 and strut junctions at an end of a second section 708.
  • FIG.37 illustrates the bendability of the shaft 700 at each of the second sections 708.
  • the shaft 700 can also be configured to compress in the axial direction.
  • the struts 702 of the shaft comprises a shape memory metal, such as Nitinol.
  • the shaft 700 is arranged over the crimp balloon (as shown in FIG. 37), and thus it is disposed outside of the inflation fluid path of the delivery apparatus. In such cases, an outer surface of the shaft 700 can be coated with a polymeric coating.
  • the shaft 700 is arranged underneath (within) the crimp balloon. In such cases, a polymeric coating may not be needed.
  • the first struts 742 can be configured to provide bendability to the shaft 740, while the second struts 744 can allow the shaft 740 to compress circumferentially.
  • Each section of first struts 742 comprises a plurality of first struts 742 arranged end- to-end in a zig-zag pattern that extends in a circumferential direction (around the shaft 740).
  • Each section of second struts 744 comprises a plurality of rows of second struts 744, each row comprising second struts 744 arranged end-to-end in a zig zag pattern that extends in an axial direction.
  • each row of second struts 744 connects to first struts 742 in two adjacent sections of first struts 742.
  • the shaft 740 can be coupled between the balloon shaft 756 and the inflation balloon 758.
  • the delivery apparatus 750 can be the same or similar to the delivery apparatuses 200, 320 or 420, as described above, except for the inclusion of the shaft 740 over the crimp balloon (or underneath in some examples).
  • the delivery apparatus 750 comprises the balloon shaft 756 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 750 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis of the delivery apparatus 750.
  • the delivery apparatus 750 further comprises an inner shaft 757 extending through the balloon shaft 756 to a polymeric body (for example, distal shoulder 759) mounted on the distal end of inner shaft 757.
  • FIGS.41-42 show an exemplary shaft 760 in a flattened configuration (full view shown in FIG.41 and a detail view of a portion of the shaft 760 shown in FIG.42).
  • the shaft 760 comprises a plurality of interconnected struts 762 forming a diamond lattice structure.
  • the struts 762 define openings or cells 764 having a diamond shape.
  • the lattice structure of the shaft 760 can be similar to that of shaft 720, except the struts 762 can include alternating cuts 766 that extend into the strut 762 from opposing edges 768 of the strut 762, as shown in the detail view of FIG.42. Each cut 766 can extend into the strut 762 from a first one of the opposing edges 768 but not all the way to a second one of the opposing edges 768. In this manner, each strut 762 with cuts 766 has a serpentine pattern along the strut where the cuts are present.
  • the shaft 780 also comprises second and third sections 784, 785 of alternating second struts 786 and third struts 787 (which correspond to and may be the same as the first struts 742 and second struts 744, respectively, of the shaft 740, as described above).
  • the shaft 780 also comprises a fourth section 788 of straight struts 789 that are spaced circumferentially apart around the shaft 780. Each straight strut 789 can extend between second struts 786 of the second section 784 and second struts 786 of the third section 785.
  • the struts of the sections of the shaft 780 can be interconnected such that all of the sections of the shaft 780 are continuous with one another.
  • the shaft 780 can be coupled between the balloon shaft 792 and the distal shoulder 794 (and/or the nose cone 796) of the delivery apparatus 790.
  • the delivery apparatus 790 can be the same or similar to the delivery apparatuses 200, 320 or 420, as described above, except for the inclusion of the shaft 780 over the crimp balloon (or underneath in some examples).
  • the delivery apparatus 790 comprises the balloon shaft 792 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 790 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis of the delivery apparatus 790.
  • the delivery apparatus 790 further comprises an inner shaft extending through the balloon shaft 792 to a polymeric body (for example, distal shoulder 794 and nose cone 796) mounted on the distal end of inner shaft.
  • the shaft can be configured such that the fourth section 788 is arranged over (or underneath in some examples) the inflation balloon of the delivery apparatus 790 and forms a region 798 that is configured to receive the radially compressed prosthetic valve thereon prior to inflating the inflation balloon for deploying the prosthetic valve at an implantation site.
  • the second and third section 784, 784 can form compressible shoulders on both sides of the region 798.
  • the prosthetic valve For delivery through a patient’s vasculature, toward an implantation site, the prosthetic valve can be mounted in a radially compressed configuration around a portion of the first section 782. Once inside the patient’s vasculature, the prosthetic valve can be slid from the first section 782 to the fourth section 788, such as by moving an outer shaft 222 (shown in FIG.5A) distally relative to the balloon shaft 792 and/or moving the balloon shaft 792 proximally relative to the outer shaft 222, as previously described.
  • the delivery apparatus can be advanced to position the prosthetic valve within a native valve annulus (e.g., a native aortic valve) and the balloon can be inflated to expand the prosthetic valve.
  • a native valve annulus e.g., a native aortic valve
  • the balloon can be inflated to expand the prosthetic valve.
  • the shaft 780 can provide structural support for the prosthetic valve, while also being bendable and compressible, thereby enabling the delivery apparatus 790 to navigate through bends in the patient’s vasculature and deploy the prosthetic valve by inflating the inflation balloon.
  • FIGS.46A-46E show relatively rigid tubes or shafts (which can be referred to herein as “crimp balloon shafts”) that can be used to support a sleeve/crimp balloon of a delivery apparatus (e.g., crimp balloon 225 shown in FIG.45).
  • the shafts or tubes shown in FIGS.46A-46E can replace the tube 229 in FIG.45, thereby extending underneath and through the crimp balloon 225.
  • the shafts or tubes shown in FIGS.46A-46E particularly if they are axially compressible, can extend from the balloon shaft, through the inflatable balloon, and to a distal end of the delivery apparatus.
  • the shafts or tubes shown in FIGS.46A-46E can extend from the balloon shaft to a proximal end portion of the inflatable balloon.
  • a shaft 800 comprising a plurality of apertures 802 (which can also be referred to as holes, openings, or pores) along its length is depicted.
  • the shaft 800 can be configured to be arranged underneath a crimp balloon and extend between (and, in some instances, couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 800 can be used in lieu of tube 229 in FIG.45).
  • the apertures 802 can be configured to provide fluid communication between an inner lumen of the shaft 800, which is fluidly connected to inner lumens of the balloon shaft (e.g., balloon shaft 226 shown in FIG.45) and the inflatable balloon (e.g., balloon 28 shown in FIG.45). As such, inflation fluid can pass through the apertures 802 into the crimp balloon (e.g., crimp balloon 225 shown in FIG.45) to allow partial inflation of the crimp balloon, for example.
  • the crimp balloon e.g., crimp balloon 225 shown in FIG.45
  • the apertures 802 can have varying diameters (e.g., at least one aperture 802 can have a different diameter than another aperture 802). [0464] The apertures 802 can be spaced apart along a majority of a length of the shaft 800. [0465] In some examples, the apertures 802 can be spaced apart along an entire length of the shaft 800. [0466] In some examples, as shown in FIG.46A, the apertures 802 can be spaced apart and extend around the shaft 800 in a spiral or helical pattern.
  • the shape, size, and pattern of the apertures 802 along the length of the shaft 800 can be specified such that it provides effective torque transfer between the opposing ends of the shaft 800, while maintaining flexibility of the shaft 800 (so it can bend).
  • the shaft 800 comprises a polymer with increased flexibility, it may not include apertures 802.
  • FIG.46B shows a shaft 810 comprising a plurality of spaced apart apertures 812 (which can also be referred to as holes or openings).
  • the shaft 810 can be configured to be arranged underneath a crimp balloon and extend between (and, in some instances, couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 810 can be used in lieu of tube 229 in FIG.45).
  • the shaft 810 comprises metal (e.g., stainless steel).
  • the apertures 812 can be configured (e.g., sized, shaped, and arranged along the shaft 810) to provide flexibility to the shaft 810 (particularly when the shaft 810 is metal), while maintaining enough rigidity to effectively transfer torque from a first end of the shaft 810 (e.g., the end coupled to the balloon shaft) to an opposite, second end of the shaft 810 (e.g., the end coupled to the inflatable balloon).
  • a diameter of each aperture 812, spacing between adjacent apertures 812, a pattern of apertures 812 along the shaft 810, and the like can be specified to produce a shaft 810 that can bend, while also effectively transferring torque along the shaft 810.
  • the apertures 812 can provide fluid communication between the inner (or central) lumen of the shaft 810, which is fluidly connected to inner lumens of the balloon shaft (e.g., balloon shaft 226 shown in FIG.45) and the inflatable balloon (e.g., balloon 28 shown in FIG.45). As such, inflation fluid can pass through the apertures 812 into the crimp balloon (e.g., crimp balloon 225 shown in FIG.45) to allow partial inflation of the crimp balloon, for example.
  • the shaft 810 comprises a material with increased flexibility such that it can easily bend, it may not include apertures 812.
  • each row 822 of cuts is a continuous (or mostly continuous) cut 824 that extends around a circumference of the shaft 820 and forms a plurality of rings 825, each of which is formed with a projection 826 and an opposing indentation 828 (also referred to as notches).
  • a projection 826 of one ring 825 is shaped to fit within an indentation 828 of an adjacent ring 825, thereby fitting together like a puzzle.
  • the shape, size, and/or number of cuts 824 and their projections 826 and indentations 828 can vary based on a desired flexibility (bendability) of the shaft, similar to as described above with reference to the shaft 300.
  • the cuts 824 allow the shaft 820 to compress axially (in an axial direction defined along a central longitudinal axis of the shaft and delivery apparatus).
  • the shaft 820 can extend underneath the inflatable balloon to a distal end portion of the delivery apparatus.
  • FIG.46D shows a shaft 830 comprising a braided mesh body 832 (or woven mesh body) extending between first and second end portions 834, 836 of the shaft 830.
  • the shaft 830 can be configured to be arranged underneath a crimp balloon and extend between (and couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 830 can be used in lieu of tube 229 in FIG.45).
  • the shaft 830 comprises metal (e.g., stainless steel).
  • the braided mesh body 832 comprises a plurality of strands 838 (e.g., round or flat metal strands) that are woven together to define the mesh structure and openings 839 between overlapping strands 838.
  • This structure allows the shaft 830 to bend.
  • this woven or braided mesh structure allows the shaft 830 to compress axially.
  • the shaft 830 can compress radially (in the radial direction which is perpendicular to the axial direction and a central longitudinal axis of the shaft 830). As a result, when a prosthetic valve is crimped thereon, the shaft 830 can compress radially to reduce an overall crimp profile of the prosthetic valve on the delivery apparatus.
  • one or both of the first end portion 834 and the second end portion 836 can have a relatively solid or non-braided surface that is configured to couple (e.g., via bonding by reflowing a polymer over the end portion) to either the inflatable balloon or the balloon shaft.
  • FIG.46E shows a shaft in the form of a coil spring 840 (which can also be referred to herein as a “coil”).
  • the coil spring 840 can be configured to be arranged underneath (within) a crimp balloon and extend from a balloon shaft to an inflatable balloon (e.g., the coil spring 840 can be used in lieu of tube 229 in FIG.45).
  • the coil spring 840 comprises metal (e.g., stainless steel).
  • the coil spring 840 comprises a polymer.
  • a pitch 842 and/or thickness of the material of the coil spring 840 can be specified such that the coil spring 840 can bend, while also being able to support a prosthetic valve mounted thereon and transmit torque along its length.
  • the coil spring 840 can be radially compressible, such that it can be crimped radially inward with the prosthetic valve.
  • Due to its coiled structure, the coil spring 840 can allow inflation fluid to pass therethrough and allow a crimp balloon surrounding the coil spring 840 to inflate.
  • FIGS.47A-47D depict an example of assembling the coil spring 840 with an inflatable balloon (e.g., inflatable balloon 228 comprising proximal balloon leg 850), crimp balloon 225, and balloon shaft 226.
  • the coil spring 840 comprises a first end portion 844 and a second end portion 846, the second end portion 846 disposed opposite the first end portion 844.
  • FIG.47D depicts the bendability of the coil spring 840.
  • FIG.46F shows a portion of a coiled wire shaft 860 comprising multiple layers of coiled wire.
  • the coiled wire shaft 860 can be configured to be arranged underneath (within) a crimp balloon and extend from a balloon shaft to an inflatable balloon (e.g., the coiled wire shaft 860 can be used in lieu of tube 229 in FIG.45).
  • the coiled wire shaft 860 comprises metal (e.g., stainless steel).
  • the coiled wire shaft 860 comprises a first layer 862 of coiled wire coiling in a first direction and a second layer 864 of coiled wire coiling in a second direction that is different from the first direction (e.g., opposite the first direction).
  • the coiled wire shaft 860 can comprise more than two layers of coiled wire, such as three, four, five layers or the like.
  • the multiple layers of coils can alternate coiling in opposite directions.
  • multiple layers of coiled wire that coil or revolve in different directions can reduce the likelihood of the coils opening or collapsing when torqued in one or both directions.
  • the shaft 860 can be more robust and more effectively transfer torque along its length.
  • the coiled wire of the coiled wire shaft 860 can be a flat wire (as shown in FIG.46F), a round wire (as shown in FIG.46G), or combinations thereof.
  • FIG.47G shows a portion of a coiled wire shaft 870 comprising a single layer of coiled wire.
  • FIGS.48-50 depict an exemplary inflatable balloon 900 that comprises an inflatable body 902, a distal leg 904 (or end portion), and a proximal leg 906 (or end portion).
  • the distal leg 904 can be configured to be coupled to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG.6).
  • the proximal leg 906 can be longer than a proximal leg of a more traditional inflatable balloon (e.g., longer than the proximal leg of the balloon 228 in FIGS.2 and 5) and extends underneath the crimp balloon 225 (as shown in FIGS.48 and 50).
  • the balloon 900 can replace the inflatable balloon 228 in the delivery apparatus 200.
  • the proximal leg 906 has a length 908 that is longer than a crimped height 910 of the prosthetic valve 912 to be mounted thereon (as shown in FIG.50). It should be noted that the length 908 of the proximal leg 906 may be longer than actual in FIG.50, for the purpose of illustration, and in some instance the length 908 may be closer to the crimped height 910 of the prosthetic valve than shown in FIG.50.
  • the proximal leg 906 is longer than the crimp balloon 225 and the proximal end 914 of the crimp balloon 225 is bonded to and around (e.g., by reflowing a polymer) the proximal leg 906, proximal to the balloon shaft (as shown in the example of FIG.50).
  • a distal end 916 of the crimp balloon 225 can be bonded to the proximal leg 906, adjacent to the inflatable body 902 of the balloon 900, as shown in the example of FIG.50.
  • the balloon 900 comprises a polymer.
  • the proximal leg 906 has stiffness that is greater than a stiffness of the inflatable body 902 of the balloon 900.
  • the stiffness can be relatively high and specified such that the proximal leg 906 can provide support for the prosthetic valve 912 crimpled thereon and provide effective torque transfer along its length (during an implantation procedure).
  • the proximal leg 906 can still be configured to bend as it is navigated through bends in a patient’s anatomy.
  • An outer diameter 918 of the proximal leg 906 can be relatively small to minimize a crimp profile of the prosthetic valve 912 mounted thereon. This outer diameter 918 can be customized for each size of valve.
  • the outer diameter 918 of the proximal leg 906 can be less than 5 mm.
  • the proximal leg 906 comprises a plurality of holes 920 spaced apart along its length 908.
  • the holes 920 can extend through an entire thickness of the proximal leg (from a lumen defined by the proximal leg 906 to an outer surface of the proximal leg 906), and thus can be configured to allow inflation fluid therethrough and inflation and deflation of the crimp balloon 225.
  • the width or diameter of the holes 920 can be specified such that inflation fluid can pass therethrough and allow inflation/deflation of the crimp balloon 225.
  • the holes 920 can all have the same diameter.
  • At least one hole 920 can have a different diameter than another hole 920.
  • a number of the holes 920 can also be specified to allow for optimal inflation and deflation of the crimp balloon 225.
  • the proximal leg 906 may not include any holes 920, and instead may be configured to bend and transfer torque.
  • the holes 920 can be spaced apart along an entire length 908 of the proximal leg 906. A spacing between adjacent holes 920 can be specified based on a desired amount of inflation fluid to pass therethrough to the crimp balloon 225.
  • the holes 920 can be spaced apart and spiral around a circumference of the proximal leg 906, as they extend along the proximal leg 906, as shown in FIGS.48-50. [0532] In some examples, the holes 920 can be arranged in a different pattern along the proximal leg 906, such as in circumferentially extending rings of spaced apart holes 920, where the rings are spaced axially apart along the proximal leg 906. [0533] In some examples, the holes 920 can have different shapes, such as circular, oblong, square, rectangular, triangular, or the like.
  • FIGS.51-52B depict an exemplary inflatable balloon 1000 that comprises an inflatable body 1002, a distal leg 1004 (or end portion), and a proximal leg 1006 (or end portion).
  • the distal leg 1004 can be configured to be coupled to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG.6).
  • the proximal leg 1006 can be longer than a proximal leg of a more traditional inflatable balloon (e.g., longer than the proximal leg of the balloon 228 in FIGS.2 and 5) and can replace (or serve as) the crimp balloon.
  • the balloon 1000 can replace the inflatable balloon 228 in the delivery apparatus 200 and the proximal leg 1006 can replace the crimp balloon. In this way, a delivery apparatus including the balloon 1000 does not need an additional crimp balloon.
  • the proximal leg 1006 has a length 1008 that is longer than a crimped height of the prosthetic valve to be mounted thereon. [0538] In some examples, the proximal leg 1006 can extend and couple to a distal end of the balloon shaft (e.g., balloon shaft 226 of delivery apparatus 200 in FIG.2 or balloon shaft 326 of FIG.6). [0539]
  • the balloon 1000 comprises a polymer.
  • each recess 1010 extends from an outer surface 1020 of the proximal leg 1006 toward, but spaced away from, a lumen 1018 (which may be a central lumen) of the proximal leg 1006.
  • the lumen 1018 is configured to receive inflation fluid therethrough, which passes into an interior of the inflatable body 1002 of the balloon 1000.
  • one or more of the recesses 1010 are annular recesses that each extend around an entire circumference of the proximal leg 1006.
  • one or more of the recesses 1010 are semi-annular recesses that each extend around a portion of the entire circumference of the proximal leg 1006.
  • a depth 1014 of the recesses 1010, a width 1016 of the recesses 1010, and/or a spacing 1015 (or distance) between adjacent recesses 1010 can be specified such that the proximal leg 1006 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure).
  • the recesses 1010 can be formed by laser etching the proximal leg of the balloon 1000.
  • a thin polymeric film 1022 (or sleeve or layer of tubing) can be disposed over the outer surface 1020 of the proximal leg 1006, thereby allowing the prosthetic valve to move (slide) from the proximal leg 1006 to the body 1002 of the balloon 1000 with greater ease.
  • the thin polymeric film 1022 can be a polymeric coating, film, or tubing, that reduces friction between the prosthetic valve and the proximal leg 1006.
  • FIGS.53-55C depict an exemplary balloon 1100 that comprises an inflatable body 1102, a distal leg 1104 (or end portion), and a proximal leg 1106 (or end portion).
  • the cuts, openings, recesses, materials, and/or lumens in the various shafts described herein provide flexibility to the shaft so that the shaft can bend as the delivery apparatus navigates curves in a patient’s vasculature.
  • the various shafts described herein can be axially compressible, thereby enabling such shafts to extend underneath an inflatable balloon and shorten as the inflatable balloon inflates.
  • the prosthetic valve can be crimped on the distal end portion of a delivery apparatus at a location offset from the central portion of an inflatable balloon (e.g., balloon 228), such as on a crimp balloon (any crimp balloon disclosed herein), a proximal leg of a balloon (such as shown in FIGS.48-56B), or on a shaft extending from the balloon shaft to the inflatable balloon (such as shown in FIGS.6- 18, 26-27B, 35-47D, 57A-63, and 70) or from a proximal end portion of the delivery apparatus to the inflatable balloon (such as shown in FIGS.64-68).
  • an inflatable balloon e.g., balloon 228, such as on a crimp balloon (any crimp balloon disclosed herein), a proximal leg of a balloon (such as shown in FIGS.48-56B), or on a shaft extending from the balloon shaft to the inflatable balloon (such as shown in FIGS.6- 18, 26-27B, 35-47D,
  • a prosthetic valve can be implanted within the native aortic valve in a transapical procedure, whereby the prosthetic valve (on the distal end portion of the delivery apparatus) is introduced into the left ventricle through a surgical opening in the chest and the apex of the heart and the prosthetic valve is positioned within the native aortic valve.
  • the prosthetic valve and the distal end portion of the delivery apparatus are inserted into a femoral vein and are advanced into and through the inferior vena cava, into the right atrium, across the atrial septum (through a puncture made in the atrial septum), into the left atrium, and toward the native mitral valve.
  • a prosthetic valve can be implanted within the native mitral valve in a transapical procedure, whereby the prosthetic valve (on the distal end portion of the delivery apparatus) is introduced into the left ventricle through a surgical opening in the chest and the apex of the heart and the prosthetic valve is positioned within the native mitral valve.
  • the prosthetic valve For implanting a prosthetic valve within the native tricuspid valve, the prosthetic valve is mounted in a radially compressed state along the distal end portion of a delivery apparatus.
  • the prosthetic valve and the distal end portion of the delivery apparatus are inserted into a femoral vein and are advanced into and through the inferior vena cava, and into the right atrium, and the prosthetic valve is positioned within the native tricuspid valve.
  • a similar approach can be used for implanting the prosthetic valve within the native pulmonary valve or the pulmonary artery, except that the prosthetic valve is advanced through the native tricuspid valve into the right ventricle and toward the pulmonary valve/pulmonary artery.
  • Another delivery approach is a transatrial approach whereby a prosthetic valve (on the distal end portion of the delivery apparatus) is inserted through an incision in the chest and an incision made through an atrial wall (of the right or left atrium) for accessing any of the native heart valves. Atrial delivery can also be made intravascularly, such as from a pulmonary vein. Still another delivery approach is a transventricular approach whereby a prosthetic valve (on the distal end portion of the delivery apparatus) is inserted through an incision in the chest and an incision made through the wall of the right ventricle (typically at or near the base of the heart) for implanting the prosthetic valve within the native tricuspid valve, the native pulmonary valve, or the pulmonary artery.
  • the delivery apparatus can be advanced over a guidewire previously inserted into a patient’s vasculature. Moreover, the disclosed delivery approaches are not intended to be limited. Any of the prosthetic valves disclosed herein can be implanted using any of various delivery procedures and delivery devices known in the art. [0684] Any of the systems, devices, apparatuses, etc. herein can be sterilized (for example, with heat/thermal, pressure, steam, radiation, and/or chemicals, etc.) to ensure they are safe for use with patients, and any of the methods herein can include sterilization of the associated system, device, apparatus, etc. as one of the steps of the method. Examples of heat/thermal sterilization include steam sterilization and autoclaving.
  • Example 3 The delivery apparatus of any example herein, particularly example 1, wherein the plurality of openings or cuts extend in a radial direction through at least a portion of a thickness of the third shaft, the thickness defined between a radially outward facing surface and a radially inward facing surface of the third shaft.
  • Example 3 The delivery apparatus of any example herein, particularly either example 1 or example 2, further comprising a crimp balloon extending along the third shaft, and wherein the second shaft extends through the inside of the crimp balloon.
  • Example 4 The delivery apparatus of any example herein, particularly example 3, wherein the third shaft is arranged inside the crimp balloon.
  • Example 17 The delivery apparatus of any example herein, particularly any one of examples 1-15, wherein the first end of the third shaft comprises proximal struts that are spaced circumferentially apart around the first end and that flare outward from a body of the third shaft and spiral along the distal end of the first shaft, wherein each proximal strut clamps to an outer surface of the distal end of the first shaft.
  • each proximal strut includes an aperture in its attached end, the attached end connecting to the body of the third shaft, and wherein the aperture is configured to provide strain relief to the proximal strut.
  • Example 29 The delivery apparatus of any example herein, particularly any one of examples 1-27, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another.
  • Example 29 The delivery apparatus of any example herein, particularly example 28, wherein the third shaft is coaxial with the first and second shafts.
  • Example 30 The delivery apparatus of any example herein, particularly either example 28 or example 29, further comprising a fourth shaft that extends distally from the handle and surrounds the first shaft, wherein the first shaft extends distal to a distal end of the fourth shaft, and wherein the handle comprises an adjustment mechanism configured to adjust a curvature of a distal end portion of the fourth shaft.
  • Example 31 An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 1-30, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft.
  • Example 32 The assembly of any example herein, particularly example 31, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve.
  • Example 33 An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 1-30, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft.
  • Example 41 The delivery apparatus of any example herein, particularly either example 38 or example 39, wherein the first portion of the plurality of repeating cuts are a plurality of circumferentially extending cuts that are spaced axially apart along the third shaft, and wherein each circumferentially extending cut forms a plurality of alternating projections in the third shaft that interlock with one another around the third shaft and allow the first section to bend and compress in the axial direction.
  • Example 41 The delivery apparatus of any example herein, particularly any one of examples 38-40, wherein the second portion of the plurality of repeating cuts are a plurality of circumferentially extending rows of cuts, wherein each row of cuts comprises a plurality of circumferential cuts that are spaced apart around the third shaft.
  • Example 42 Example 42.
  • Example 47 The delivery apparatus of any example herein, particularly either example 45 or example 46, wherein the polymeric body is a distal shoulder. [0733] Example 48.
  • each circumferential cut comprises two end portions and a body extending between the two end portions, wherein each end portion is wider than the body of the circumferential cut.
  • Example 51 The delivery apparatus of any example herein, particularly example 50, wherein each end portion is circular.
  • Example 52 The delivery apparatus of any example herein, particularly example 52, wherein each end portion is circular.
  • Example 54 The delivery apparatus of any example herein, particularly any one of examples 34-52, wherein one or more of the first end and a second end of the third shaft comprises a plurality of struts that are spaced circumferentially apart around the one or more of the first end and second end and that flare outward from a body of the third shaft.
  • Example 54 The delivery apparatus of any example herein, particularly example 53, wherein the first end of the third shaft comprises the plurality of struts, and wherein the plurality of struts clamp to an outer surface of the distal end of the first shaft.
  • Example 55 Example 55.
  • Example 62 The delivery apparatus of any example herein, particularly any one of examples 34-60, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another.
  • Example 62 The delivery apparatus of any example herein, particularly example 61, wherein the third shaft is coaxial with the first and second shafts.
  • Example 63 Example 63.
  • Example 66 The assembly of any example herein, particularly example 64, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve.
  • a delivery apparatus for a prosthetic device comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a third shaft extending along the crimp balloon, wherein the third shaft has a first end coupled to the distal end of the first shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft comprises a plurality of interconnected struts that define a plurality of open cells.
  • Example 68 The delivery apparatus of any example herein, particularly either example 66 or example 67, wherein the plurality of open cells are diamond-shaped cells with a long dimension of the diamond-shaped cells extending in an axial direction relative to a central longitudinal axis of the delivery apparatus.
  • Example 69 The delivery apparatus of any example herein, particularly example 66, wherein at least a portion of the third shaft is compressible in a radial direction and configured to receive a prosthetic device thereon in a radially compressed configuration.
  • Example 70 The delivery apparatus of any example herein, particularly any one of examples 66-68, wherein the third shaft comprises alternating first sections and second sections, wherein each first section comprises first cells of the plurality of opens cells having a long dimension extending in an axial direction, and wherein each second section comprises second cells of the plurality of open cells having a long dimension extending in a circumferential direction.
  • Example 70 The delivery apparatus of any example herein, particularly example 69, wherein each second section is disposed between two adjacent first sections, and wherein struts defining the second cells of each second section are directly connected to struts defining the first cells of the two adjacent first sections.
  • Example 71 Example 71.
  • each second section is configured to bend around a central longitudinal axis of the delivery apparatus, and wherein each first section is configured to compress in a radial direction which is defined relative to the central longitudinal axis.
  • Example 72 The delivery apparatus of any example herein, particularly any one of examples 69-71, wherein one first section is coupled to the distal end of the balloon shaft, and wherein another first section is coupled to a proximal end portion of the inflatable balloon.
  • Example 73 The delivery apparatus of any example herein, particularly any one of examples 69-72, wherein a length of each first section, as defined in the axial direction, is longer than a length of each second section.
  • Example 78 The delivery apparatus of any example herein, particularly any one of examples 66-76, wherein the plurality of interconnected struts comprises metal.
  • Example 78 The delivery apparatus of any example herein, particularly example 77, wherein the metal is Nitinol.
  • Example 79 The delivery apparatus of any example herein, particularly any one of examples 66-78, wherein the third shaft extends over the crimp balloon.
  • Example 80 The delivery apparatus of any example herein, particularly example 79, wherein the third shaft is coated with a polymeric coating.
  • Example 81 The delivery apparatus of any example herein, particularly any one of examples 66-78, wherein the third shaft extends underneath the crimp balloon.
  • Example 82 The delivery apparatus of any example herein, particularly any one of examples 66-78, wherein the third shaft extends underneath the crimp balloon.
  • Example 83 The delivery apparatus of any example herein, particularly any one of examples 66-81, wherein a second end of the third shaft is coupled to a polymeric body mounted on a distal end of the second shaft, the second end disposed opposite the first end, and wherein the third shaft extends through the inflatable balloon.
  • Example 84 The delivery apparatus of any example herein, particularly any one of examples 66-81, wherein a second end of the third shaft is coupled to a polymeric body mounted on a distal end of the second shaft, the second end disposed opposite the first end, and wherein the third shaft extends through the inflatable balloon.
  • Example 85 The delivery apparatus of any example herein, particularly any one of examples 66-83, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another.
  • Example 85 The delivery apparatus of any example herein, particularly example 84, wherein the third shaft is coaxial with the first and second shafts.
  • Example 86 Example 86.
  • Example 87 An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 66-86, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft.
  • Example 88 An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 66-86, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft.
  • the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve.
  • a delivery apparatus for a prosthetic device comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a third shaft extending along the crimp balloon, outside of the second shaft, and having a first end coupled to the distal end of the first shaft, wherein a proximal end of the inflatable balloon is coupled to the third shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft is configured to bend relative to a central longitudinal axis of the delivery apparatus.
  • each circumferential cut comprises two end portions and a body extending between the two end portions, wherein the body is elongated relative to the two end portions.
  • Example 97 The delivery apparatus of any example herein, particularly example 96, wherein each end portion is wider than a width of the body, the width defined in the axial direction.
  • Example 98 The delivery apparatus of any example herein, particularly any one of examples 95-97, wherein the circumferential cuts of each row of cuts are staggered in the axial direction relative to the circumferential cuts in immediately adjacent rows of cuts.
  • Example 99 Example 99.
  • Example 101 The delivery apparatus of any example herein, particularly either example 99 or example 100, wherein a first portion of cells of the plurality of open cells have a long dimension oriented in an axial direction relative to the central longitudinal axis and define one or more first sections of the third shaft, and wherein a second portion of cells of the plurality of open cells have a long dimension oriented in a circumferential direction.
  • Example 102 The delivery apparatus of any example herein, particularly any one of examples 90-92, wherein the third shaft comprises a plurality of interconnected struts defining a plurality of open cells.
  • Example 103 The delivery apparatus of any example herein, particularly example 102, wherein one first section is coupled to the distal end of the first shaft, and wherein another first section is coupled to the proximal end of the inflatable balloon.
  • Example 104 The delivery apparatus of any example herein, particularly any one of examples 101-103, wherein each second section is configured to bend relative to the central longitudinal axis of the delivery apparatus, and wherein each first section is configured to compress in a radial direction which is defined relative to the central longitudinal axis.
  • Example 105 Example 105.
  • Example 113 The delivery apparatus of any example herein, particularly any one of examples 89-111, wherein a second end of the first shaft comprises a plurality of struts that are spaced circumferentially apart around the second end and that flare outward from a body of the third shaft, wherein the second end is opposite the first end of the third shaft.
  • Example 113 The delivery apparatus of any example herein, particularly example 112, wherein the proximal end of the inflatable balloon comprises a plurality of holes, and wherein each axially extending strut includes an arrow-shaped tip that is inserted into a respective hole of the plurality of holes to couple the second end of the third shaft to the proximal end of the inflatable balloon.
  • Example 114 Example 114.
  • Example 118 The delivery apparatus of any example herein, particularly any one of examples 89-115, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another.
  • Example 117 The delivery apparatus of any example herein, particularly example 116, wherein the third shaft is coaxial with the first and second shafts.
  • Example 118 Example 118.
  • Example 119 The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft comprises a plurality of spaced apart apertures along its length, and wherein the third shaft extends underneath the crimp balloon. [0805] Example 120.
  • Example 121 The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft is a coil spring, and wherein the third shaft extends underneath the crimp balloon.
  • Example 121 The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft comprises a braided mesh body, and wherein the third shaft extends underneath the crimp balloon.
  • Example 122 The delivery apparatus of any example herein, particularly example 89, wherein the third shaft comprises a polymer.
  • Example 123 The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises a plurality of circumferentially and axially spaced apart apertures extending along the third shaft.
  • Example 124 The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises an axially extending central lumen and a plurality of axially extending lumens that are offset from the central lumen, and wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon.
  • Example 125 The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises an axially extending central lumen and a plurality of axially spaced recesses extending radially away from the central lumen, and wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon.
  • Example 126 Example 126.
  • Example 127 The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shift is a braided layer that extends from within the first shaft.
  • Example 127 The delivery apparatus of any example herein, particularly example 126, wherein the braided layer has a first portion that extends along a majority of a length of the first shaft and is embedded in a polymeric jacket of the first shaft, and a second portion that extends distal to a distal end of the polymeric jacket of the first shaft and defines the third shaft.
  • Example 128 The delivery apparatus of any example herein, particularly example 127, wherein the second portion of the braided layer extends along an outer surface of the third shaft to a proximal end of the inflatable balloon.
  • Example 129 The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft is a support structure bonded to a surface of the crimp balloon, wherein the support structure comprises a plurality of support struts extending along the crimp balloon.
  • Example 130 The delivery apparatus of any example herein, particularly example 129, where the plurality of support struts is bonded to an outer surface of the crimp balloon.
  • Example 131 The delivery apparatus of any example herein, particularly either example 129 or example 130, wherein the plurality of support struts includes a plurality of longitudinally extending struts that extend between opposing ends of the support structure.
  • Example 132 Example 132.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a coil extending underneath the crimp balloon.
  • Example 135. The delivery apparatus of any example herein, particularly example 134, wherein the coil extends between the first shaft and the inflatable balloon.
  • Example 136 The delivery apparatus of any example herein, particularly either example 134 or example 135, wherein the coil is a metal spring.
  • Example 137 The delivery apparatus of any example herein, particularly any one of examples 134-136, wherein opposing end portions of the coil have a larger pitch than a main body of the coil.
  • Example 138 The delivery apparatus of any example herein, particularly any one of examples 134-137, wherein a first end portion of the coil is arranged within a proximal leg of the inflatable balloon.
  • Example 139 The delivery apparatus of any example herein, particularly example 138, wherein a first end portion of the crimp balloon is bonded to the proximal leg of the inflatable balloon, around the first end portion of the coil.
  • Example 140 Example 140.
  • Example 141 The delivery apparatus of any example herein, particularly example 140, wherein a second end portion of the crimp balloon is bonded to the distal end of the first shaft, around the second end portion of the coil.
  • Example 142 The delivery apparatus of any example herein, particularly any one of examples 134-139, wherein a second end portion of the coil is arranged within the distal end of the first shaft.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, wherein the inflatable balloon comprises an inflatable body and a proximal leg extending proximally from the inflatable body toward the distal end of the first shaft, wherein the proximal leg has a stiffness specified such that it can transfer torque along its length and bend.
  • Example 143 The delivery apparatus of any example herein, particularly example 142, wherein the proximal leg extends to the distal end of the first shaft.
  • Example 145 The delivery apparatus of any example herein, particularly either example 142 or example 143, wherein the proximal leg has a length that is sized to be longer than a radially compressed prosthetic device.
  • Example 145 The delivery apparatus of any example herein, particularly any one of examples 142-144, wherein the stiffness of the proximal leg is greater than a stiffness of the inflatable body.
  • Example 146 The delivery apparatus of any example herein, particularly any one of examples 142-145, wherein the proximal leg comprises a plurality of openings spaced apart along its length.
  • Example 147 Example 147.
  • Example 150 The delivery apparatus of any example herein, particularly either example 148 or example 149, further comprising a crimp balloon extending around the proximal leg and coupled between the distal end of the first shaft and the inflatable balloon.
  • Example 151 The delivery apparatus of any example herein, particularly either example 146 or example 147, wherein the plurality of openings is a plurality of recesses spaced axially apart along a length of the proximal leg, and wherein each recess of the plurality of recesses extents from an outer surface of the proximal leg toward a central lumen of the proximal leg.
  • Example 152 Example 152.
  • Example 153 The delivery apparatus of any example herein, particularly example 151, further comprising a thin film covering the proximal leg.
  • Example 153 The delivery apparatus of any example herein, particularly example 151, further comprising a thin polymeric sleeve covering the proximal leg.
  • Example 154 The delivery apparatus of any example herein, particularly any one of examples 142-145, wherein the proximal leg comprises a plurality of longitudinal pleats.
  • Example 155 Example 155.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft having a first end coupled to the distal end of the first shaft and a second end coupled to a proximal end of the inflatable balloon, wherein the second shaft extends through a central lumen of the third shaft, and wherein the third shaft is fluidly sealed around its outer surface and has a plurality of internal lumens or recesses that enable the third shaft to bend.
  • Example 157 The delivery apparatus of any example herein, particularly example 155, wherein the third shaft has a stiffness that enables it to transfer torque from the first shaft to the second end of the third shaft and radially compress.
  • Example 157 The delivery apparatus of any example herein, particularly either example 155 or example 156, wherein the plurality of internal lumens or recesses is a plurality of lumens, and wherein each lumen of the plurality of lumens is radially offset from the central lumen and circumferentially offset from adjacent lumens of the plurality of lumens.
  • Example 158 The delivery apparatus of any example herein, particularly example 157, wherein each lumen extends axially along the third shaft and has a circular cross-section.
  • Example 159 The delivery apparatus of any example herein, particularly example 157, wherein each lumen extends axially along the third shaft and has a non-circular cross- section.
  • Example 160 The delivery apparatus of any example herein, particularly either example 155 or example 156, wherein the plurality of internal lumens or recesses is a plurality of recesses, and wherein each recess of the plurality of recesses extends from the central lumen through the third shaft toward the outer surface of the third shaft.
  • Example 161 The delivery apparatus of any example herein, particularly example 160, wherein each recess extends in a radial direction and is spaced axially apart from adjacent recesses.
  • each recess is an annular recess.
  • Example 163 The delivery apparatus of any example herein, particularly any one of examples 155-162, wherein the third shaft comprises a polymer.
  • Example 164 Example 164.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a braided tube comprising a first portion extending within the first shaft and a second portion that extends outward from a distal end of the first shaft to a proximal end of the inflatable balloon, and wherein the second portion is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated.
  • Example 166 The delivery apparatus of any example herein, particularly example 164, wherein the first portion extends through a distal end portion of the first shaft, wherein the braided tube is a first braided tube, and wherein the first shaft comprises a second braided tube extending along a majority of a length of the first shaft.
  • Example 167 The delivery apparatus of any example herein, particularly example 164, wherein the first portion extends within a majority of a length of the first shaft and is embedded in a polymeric jacket of the first shaft.
  • Example 166 The delivery apparatus of any example herein, particularly example 164, wherein the first portion of the braided tube extends through a distal end portion of the first shaft, wherein the braided tube is a first braided tube, and wherein the first shaft comprises a second braided tube extending along a majority of a length of the first shaft.
  • Example 168 The delivery apparatus of any example herein, particularly any one of examples 164-166, further comprising a crimp balloon extending along the second portion of the braided tube, and wherein the second shaft extends through the inside of the crimp balloon.
  • Example 168 The delivery apparatus of any example herein, particularly example 167, wherein the second portion of the braided tube is arranged inside the crimp balloon.
  • Example 169 The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second shaft extends through the second portion of the braided tube, and wherein the second portion of the braided tube is spaced apart from the second shaft.
  • Example 170 Example 170.
  • Example 171 The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second shaft extends through the second portion of the braided tube, and wherein the second portion of the braided tube tapers radially inward from the distal end of the first shaft to the second shaft and extends along and contacts an outer surface of the second shaft.
  • Example 171 The delivery apparatus of any example herein, particularly example 170, wherein the second portion of the braided tube is crimped onto the second shaft, along a portion of the second shaft that extends between the balloon shaft and the inflatable balloon.
  • Example 173 The delivery apparatus of any example herein, particularly example 171, further comprising a polymeric sleeve covering the second portion of the braided tube that is crimped onto the second shaft.
  • Example 173 The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second portion of the braided tube comprises a larger diameter segment extending outward from the distal end of the first shaft, a smaller diameter segment extending along the outer surface of the second shaft, and a stepped segment that transitions between the larger diameter segment and the smaller diameter segment.
  • Example 174 Example 174.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a support structure arranged along the crimp balloon, wherein the support structure comprises a plurality of spaced apart support struts extending along a surface of the balloon.
  • Example 177 The delivery apparatus of any example herein, particularly example 174, wherein the support structure is bonded to an inner surface of the crimp balloon.
  • Example 177 The delivery apparatus of any example herein, particularly any one of examples 174-176, wherein the support structure comprises metal.
  • Example 178 The delivery apparatus of any example herein, particularly any one of examples 174-177, wherein the plurality of struts includes a plurality of longitudinally extending struts that are spaced circumferentially apart from one another.
  • Example 179 Example 179.
  • Example 180 The delivery apparatus of any example herein, particularly any one of examples 174-178, wherein the support structure comprises coiled wires, and wherein ends of the plurality of supports struts are held together around the crimp balloon with the coiled wires. [0866] Example 181.
  • a delivery apparatus for a prosthetic device comprising a handle; a rotatable first shaft, wherein the first shaft has a first segment with a first diameter and a second segment with a second diameter that is smaller than the first diameter, wherein the first segment extends from the handle and defines a majority of a length of the first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft; wherein the second segment of the first shaft extends from the first segment toward a proximal end of the inflatable balloon and is configured to receive a prosthetic valve in a radially compressed configuration.
  • Example 183 The delivery apparatus of any example herein, particularly example 181, wherein a proximal end of the inflatable balloon is attached to the second segment.
  • Example 183 The delivery apparatus of any example herein, particularly example 181, wherein the first shaft further comprises a third segment with a third diameter that is larger than the second diameter, and wherein the third segment extends between the second segment and a proximal end of the inflatable balloon.
  • Example 184 The delivery apparatus of any example herein, particularly any one of examples 181-183, wherein the first shaft comprises one or more braided layers embedded within a polymeric jacket, and wherein a thickness of the polymeric jacket of the second segment is smaller than a thickness of the polymeric jacket of the first segment.
  • Example 185 Example 185.
  • Example 186 A delivery apparatus for a prosthetic device, comprising a handle; a rotatable first shaft extending distally from the handle, wherein the first shaft is a metal tube comprising a plurality of cuts spaced axially and circumferentially apart along at least a portion of a total length of the first shaft, wherein the plurality of cuts is configured such that the first shaft is bendable; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, and wherein a proximal end portion of the inflatable balloon is bonded to a distal end portion of the first shaft.
  • Example 187 The delivery apparatus of any example herein, particularly example 186, wherein each cut of the plurality of cuts extends through a wall of the metal tube.
  • Example 188 The delivery apparatus of any example herein, particularly either example 186 or example 187, wherein the plurality of cuts in the first shaft forms a plurality of circumferentially extending rows of cuts that are spaced axially apart from one another.
  • Example 189 The delivery apparatus of any example herein, particularly either example 186 or example 187, wherein the plurality of cuts in the first shaft forms a plurality of circumferentially extending rows of cuts that are spaced axially apart from one another.
  • each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the first shaft, and wherein each individual cut is an elongated diamond shaped cut with a major axis of the elongated diamond shaped cut extending in the circumferential direction.
  • each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the first shaft, and wherein each individual cut is a slit extending in the circumferential direction.
  • Example 192 The delivery apparatus of any example herein, particularly any one of examples 186-191, wherein the plurality of cuts extends along the at least the portion of the total length first shaft but are spaced away from a distal end of the first shaft. [0878] Example 193.
  • Example 194 The delivery apparatus of any example herein, particularly any one of examples 186-193, further comprising a proximal portion disposed proximal to the handle, wherein the first and second shafts extend distally from the proximal portion and through the handle, and wherein the proximal portion is configured to receive inflation fluid for inflating the inflatable balloon.
  • Example 195 The delivery apparatus of any example herein, particularly any one of examples 186-192, wherein the distal end portion of the first shaft comprises a plurality of apertures extending radially through a wall of the metal tube, and wherein the plurality of apertures is configured to receive a reflowed polymer for bonding the first shaft to the inflatable balloon.
  • Example 196 The delivery apparatus of any example herein, particularly any one of examples 186-194, wherein a diameter of the metal tube is less than 3 mm.
  • Example 196 The delivery apparatus of any example herein, particularly any one of examples 186-195, wherein the first shaft comprises an outer polymer layer bonded to an outer surface of the metal tube.
  • Example 197 The delivery apparatus of any example herein, particularly example 196, wherein the outer polymer layer is a PEBAX heat shrink layer.
  • Example 198 Example 198.
  • a delivery apparatus for a prosthetic device comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft having a radially expandable first end portion coupled around the distal end of the first shaft, a radially expandable second end portion coupled around a proximal end of the inflatable balloon, and a body extending between the first and second end portions, wherein the body comprises a plurality of openings or cuts along its length that allows it to bend, and wherein the third shaft is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated.
  • Example 199 The delivery apparatus of any example herein, particularly example 198, wherein the plurality of openings or cuts extend in a radial direction through at least a portion of a thickness of the third shaft, the thickness defined between a radially outward facing surface and a radially inward facing surface of the third shaft.
  • Example 200 The delivery apparatus of any example herein, particularly either example 198 or example 199, wherein the plurality of openings or cuts forms a plurality of circumferentially extending rows of openings or cuts that are spaced axially apart from one another.
  • Example 201 Example 201.
  • each row of openings or cuts comprises a plurality of individual openings or cuts that are circumferentially spaced apart from one another.
  • Example 202 The delivery apparatus of any example herein, particularly any one of examples 198-201, wherein at least a portion of openings or cuts of the plurality of opening or cuts each have an elongated diamond shape with a major axis of the elongated diamond shaped cut extending in the circumferential direction.
  • Example 203 The delivery apparatus of any example herein, particularly any one of examples 198-202, further comprising a crimp balloon extending along the third shaft, and wherein the second shaft extends through the inside of the crimp balloon.
  • Example 204 The delivery apparatus of any example herein, particularly example 203, wherein the third shaft is arranged inside the crimp balloon.
  • Example 205 The delivery apparatus of any example herein, particularly either example 203 or example 204, wherein a distal end portion of the crimp balloon is bonded to the inflatable balloon and the second end portion of the third shaft.
  • Example 206 The delivery apparatus of any example herein, particularly any one of examples 203-205, wherein a proximal end portion of the crimp balloon is bonded to the distal end of the first shaft.
  • Example 207 Example 207.
  • the first end portion comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end portion, wherein the lattice structure is radially expandable such that it flares radially outward from the body of the third shaft to a free end of the lattice structure that is coupled around the distal end of the first shaft.
  • the second end portion comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end portion, wherein the lattice structure is radially expandable such that it flares radially outward from the body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon.
  • the second end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end, wherein the lattice structure is radially expandable such that flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon.
  • the first end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end, wherein the lattice structure is radially expandable such that it flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled to the distal end of the first shaft.
  • each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the third shaft, and wherein each individual cut is an elongated diamond shaped cut with a major axis of the diamond shaped cut extending in the circumferential direction.
  • the second end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end, wherein the lattice structure is radially expandable such that flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon.
  • Example 214 A method comprising sterilizing the prosthetic heart valve, apparatus, and/or assembly of any example.
  • any one or more of the features of one delivery apparatus can be combined with any one or more features of another delivery apparatus.
  • any one or more features of one crimp balloon shaft can be combined with any one or more features of another crimp balloon shaft.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Mechanical Engineering (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Delivery apparatuses including a shaft configured to receive a radially compressed prosthetic device and transfer torque from a balloon shaft to a proximal end of an inflatable balloon of the delivery apparatus are disclosed. A delivery apparatus for a prosthetic device can comprise a rotatable first shaft, a second shaft extending through the first shaft and beyond a distal end of the first shaft, an inflatable balloon arranged around a distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, around the second shaft, and a third shaft extending along the crimp balloon and having a first end coupled to the distal end of the first shaft. A proximal end of the inflatable balloon is coupled to the third shaft, the second shaft extends through the third shaft, and the third shaft is configured to bend.

Description

DELIVERY APPARATUS FOR A PROSTHETIC VALVE CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of U.S. Provisional Patent Application Nos. 63/570,698, filed March 27, 2024, 63/651,279, filed May 23, 2024, and 63/688,649, filed August 29, 2024, the entire contents of each of which are incorporated by reference herein. FIELD [0002] The present disclosure relates to delivery apparatuses for delivering and deploying prosthetic heart valves, and in particular to rotatable or torqueable shafts for the delivery apparatuses. BACKGROUND [0003] The human heart can suffer from various valvular diseases. These valvular diseases can result in significant malfunctioning of the heart and ultimately require repair of the native valve or replacement of the native valve with an artificial valve. There are a number of known repair devices (e.g., stents) and artificial valves, as well as a number of known methods of implanting these devices and valves in humans. Percutaneous and minimally- invasive surgical approaches are used in various procedures to deliver prosthetic medical devices to locations inside the body that are not readily accessible by surgery or where access without surgery is desirable. In one specific example, a prosthetic heart valve can be mounted in a crimped state on the distal end of a delivery apparatus and advanced through the patient’s vasculature (e.g., through a femoral artery and the aorta) until the prosthetic valve reaches the implantation site in the heart. The prosthetic valve is then expanded to its functional size, for example, by inflating a balloon on which the prosthetic valve is mounted, actuating a mechanical actuator that applies an expansion force to the prosthetic valve, or by deploying the prosthetic valve from a sheath of the delivery apparatus so that the prosthetic valve can self-expand to its functional size. [0004] In some examples, it may be desirable to rotate the prosthetic valve on the delivery apparatus, prior to implantation, to achieve a desired rotational or circumferential alignment of the prosthetic valve relative to the native anatomy. However, it may be difficult to effectively transmit torque to the distal end portion of the delivery apparatus where the prosthetic valve is mounted. Accordingly, a need exists for improved delivery apparatuses that can effectively rotate the prosthetic valve mounted thereon prior to deployment and implantation. SUMMARY [0005] Described herein are examples of systems and methods for delivering and implanting a prosthetic valve at a native valve of a heart of a patient. In some examples, the prosthetic valve can be mounted in a radially compressed state onto a delivery apparatus for delivery to a target implantation site and then deployed at the target implantation site (e.g., the native valve) with the delivery apparatus. The delivery apparatus can include an inflatable balloon and the prosthetic valve can be radially expanded and deployed by inflating the balloon at the target implantation site. In some examples, for delivery through a patient’s vasculature toward an implantation, the prosthetic valve is mounted off the inflatable balloon and then moved axially onto the balloon prior to deployment. [0006] The delivery apparatus can include a torqueable shaft or shaft segment that connects a rotatable balloon shaft of the delivery apparatus to the inflatable balloon. The torqueable shaft can, in some examples, comprise a tube with cuts or openings that allow it to bend (for example, when navigating through the patient’s vasculature) and also transfer torque from the balloon shaft to the distal end of the torqueable shaft, thereby enabling rotation the prosthetic valve mounted on the torqueable shaft. [0007] In some examples, the torqueable shaft can also be radially compressible, or have a small enough outer diameter such that when a prosthetic valve is crimped thereon, the integrity and durability of the prosthetic valve (e.g., the leaflets) is maintained and/or on overall crimp profile of the prosthetic valve is reduced. [0008] In some examples, the torqueable shaft or shaft segment can be an extension of a proximal end portion (or a proximal leg) of the inflatable balloon. The extended proximal end portion of the inflatable balloon can comprise holes, cuts, or the like, that provide it with flexibility. [0009] In some examples, the torqueable shaft or shaft segment can be an extension of a layer or portion of the rotatable balloon shaft, such as a braided tube layer. [0010] As a result, the prosthetic valve can be rotated into a desired position relative to the native anatomy prior to implantation. For example, the prosthetic valve can be rotated such that its commissures are rotationally aligned with commissures of a native heart valve. As such, the devices and methods disclosed herein can, among other things, overcome one or more of the deficiencies of typical prosthetic heart valves and their delivery apparatuses. [0011] A delivery apparatus for a prosthetic implant can comprise one more shafts. [0012] In some examples, the delivery apparatus can comprise a handle and the one or more shafts extend distally from the handle. [0013] In some examples, the one or more shafts includes a rotatable first shaft. [0014] In some examples, the first shaft has a smaller diameter portion and a larger diameter portion arranged between the handle and the smaller diameter portion. [0015] In some examples, the smaller diameter portion is configured to receive a prosthetic valve in a radially compressed configuration. [0016] In some examples, the one or more shafts includes a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft. [0017] In some examples, the delivery apparatus includes an inflatable balloon arranged around the distal end portion of the second shaft. [0018] In some examples, the inflatable balloon comprises an inflatable body arranged around the distal end portion of the second shaft and a proximal leg that extends toward or to the distal end of the first shaft. [0019] In some examples, the proximal leg of the balloon has a stiffness that enables it to transfer torque along its length and receive a prosthetic valve crimped thereon. [0020] In some examples, the proximal leg of the balloon has a plurality of longitudinal pleats. [0021] In some examples, the proximal leg comprises a plurality of through-holes spaced apart along its length, and the delivery apparatus comprises a crimp balloon surrounding the proximal leg. [0022] In some examples, the proximal leg comprises a plurality of axially spaced recesses extending into the shaft from its outer surface. [0023] In some examples, the delivery apparatus includes a third shaft having a first end coupled to the distal end of the first shaft. [0024] In some examples, the delivery apparatus includes a third shaft or shaft portion that extends distally outward from the first shaft. [0025] In some examples, the third shaft or shaft portion is a braided tube or braided layer of the first shaft. [0026] In some examples, the braided tube extends along the outer surface of the second shaft. [0027] In some examples, a proximal end of the inflatable balloon is coupled to the third shaft. [0028] In some examples, a second end of the third shaft is coupled to the proximal end of the inflatable balloon. [0029] In some examples, a polymeric body is mounted on the distal end of the second shaft and a second end of the third shaft is coupled to the polymeric body. [0030] In some examples, the polymeric body is a distal shoulder. [0031] In some examples, the delivery apparatus includes a crimp balloon extending between the first shaft and the inflatable balloon. [0032] In some examples, a support structure comprising a plurality of struts is bonded to a surface of the crimp balloon. [0033] In some examples, the third shaft extends over the crimp balloon. [0034] In some examples, the third shaft extends within the crimp balloon. [0035] In some examples, the third shaft comprises a plurality of openings or cuts along its length that allows it to bend and transfer torque from the first shaft to a second end of the third shaft. [0036] In some examples, the third shaft comprises a plurality of cuts that are organized into a plurality of axially spaced rows of cuts. [0037] In some examples, each row of cuts includes a cut extending around a circumference of the third shaft and defining alternating projections on both side of cuts that interlock together like puzzle pieces. [0038] In some examples, the third shaft is compressible in the axial direction. [0039] In some examples, each row of cuts includes a plurality of circumferential cuts that are spaced circumferentially apart from one another around the third shaft. [0040] In some examples, the third shaft comprises a plurality of interconnected struts that define a plurality of open cells. [0041] In some examples, the plurality of open cells forms a diamond lattice pattern. [0042] In some examples, the third shaft comprises metal. [0043] In some examples, the third shaft comprises Nitinol. [0044] In some examples, the third shaft is a coil spring. [0045] In some examples, the third shaft comprises a polymer. [0046] In some examples, the third shaft comprises a plurality of spaced apart holes extending along its length. [0047] In some examples, the third shaft comprises a plurality of axially extending lumens and a smooth outer surface. [0048] In some examples, the third shaft comprises a plurality of axially spaced internal recesses that extend from a central lumen of the third shaft toward an outer surface of the third shaft. [0049] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a third shaft having a first end coupled to the distal end of the first shaft. A proximal end of the inflatable balloon is coupled to the third shaft and the third shaft comprises a plurality of openings or cuts along its length that allows it to bend. The third shaft is configured to transfer torque from the first shaft to a second end of the third shaft when the first shaft is rotated. [0050] The second end of the third shaft is opposite the first end. [0051] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a third shaft comprising metal and having a first end coupled to the distal end of the first shaft. A proximal end of the inflatable balloon is coupled to the third shaft. The second shaft extends through the third shaft and the third shaft comprises a plurality of repeating cuts spaced apart along the third shaft. [0052] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft, and a third shaft extending along the crimp balloon. The third shaft has a first end coupled to the distal end of the first shaft. The second shaft extends through the third shaft and the third shaft comprises a plurality of interconnected struts that define a plurality of open cells. [0053] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft, and a third shaft extending along the crimp balloon, outside of the second shaft, and having a first end coupled to the distal end of the first shaft. A proximal end of the inflatable balloon is coupled to the third shaft. The second shaft extends through the third shaft, and the third shaft is configured to bend relative to a central longitudinal axis of the delivery apparatus. [0054] In some example, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft, and a coil extending underneath the crimp balloon. [0055] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, and an inflatable balloon arranged around the distal end portion of the second shaft. The inflatable balloon comprises an inflatable body and a proximal leg extending proximally from the inflatable body toward the distal end of the first shaft. The proximal leg has a stiffness specified such that it can transfer torque along its length and bend. [0056] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a third shaft having a first end coupled to the distal end of the first shaft and a second end coupled to a proximal end of the inflatable balloon. The second shaft extends through a central lumen of the third shaft. The third shaft is fluidly sealed around its outer surface and has a plurality of internal lumens or recesses that enable the third shaft to bend. [0057] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, and a braided tube comprising a first portion extending within the first shaft and a second portion that extends outward from a distal end of the first shaft to a proximal end of the inflatable balloon. The second portion is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated. [0058] In some examples, a delivery apparatus for a prosthetic device comprises a rotatable first shaft, a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, an inflatable balloon arranged around the distal end portion of the second shaft, a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft, and a support structure arranged along the crimp balloon. The support structure comprises a plurality of spaced apart support struts extending along a surface of the balloon. [0059] In some examples, a delivery apparatus for a prosthetic device comprises a handle, and a rotatable first shaft. The first shaft has a first segment with a first diameter and a second segment with a second diameter that is smaller than the first diameter. The first segment extends from the handle and defines a majority of a length of the first shaft. The delivery apparatus further comprises a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft, and an inflatable balloon arranged around the distal end portion of the second shaft. The second segment of the first shaft extends from the first segment toward a proximal end of the inflatable balloon and is configured to receive a prosthetic valve in a radially compressed configuration. [0060] In some examples, a delivery apparatus comprises one or more of the components recited in Examples 1-30, 34-63, 66-86, 89-131, 134-184, or 186-213 below. [0061] An assembly can comprise a prosthetic heart valve and the delivery apparatus described in any of the paragraphs above. [0062] In some examples, an assembly comprises one or more of the components recited in Examples 31-33, 64, 65, 87, 88, 132, 133, or 185 below. [0063] The various innovations of this disclosure can be used in combination or separately. This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter. The foregoing and other objects, features, and advantages of the disclosure will become more apparent from the following detailed description, claims, and accompanying figures. BRIEF DESCRIPTION OF THE DRAWINGS [0064] FIG.1 is a perspective view of a prosthetic heart valve, according to an example. [0065] FIG.2 is a side view of a delivery apparatus for implanting a prosthetic heart valve, according to an example. [0066] FIG.3A is a cross-sectional view of the handle of the delivery apparatus of FIG.2. [0067] FIG.3B is another cross-sectional view of the handle of the delivery apparatus of FIG.2. [0068] FIG.4 is side view of a section of the handle and a section of the distal end portion of the delivery apparatus of FIG.2. [0069] FIG.5A is a side view of the distal end portion of the delivery apparatus of FIG.2. [0070] FIG.5B is a cross-sectional side view of the distal end portion of the delivery apparatus of FIG.2. [0071] FIG.6 is a perspective view of an exemplary delivery apparatus including a shaft extending along a crimp balloon of the delivery apparatus and coupled between a balloon shaft and an inflation balloon of the delivery apparatus, where the shaft comprises puzzle- shaped cuts that allow it to bend and compress axially while also transferring torque from the balloon shaft to a distal end of the shaft. [0072] FIG.7 is a detail view of a portion of the puzzle shaft of FIG.6 showing circumferentially extending rows of cuts that are spaced axially apart along the shaft, the cuts creating puzzle-shaped connections between adjacent sections of the shaft, thereby enabling the shaft to bend and compress in the axial direction. [0073] FIG.8 is a side view of the puzzle shaft of FIG.6 in a flattened configuration. [0074] FIG.9 is a perspective view of the puzzle shaft of FIG.6, showing end portions of the puzzle shaft comprising attachment interfaces that are configured to couple to the balloon shaft and inflatable balloon. [0075] FIG.10 is a perspective view of a portion of the delivery apparatus of FIG.6 that includes the shaft of FIG.6 extending underneath the crimp balloon and coupled to the balloon shaft and inflatable balloon. [0076] FIG.11A is a perspective view of a portion of the delivery apparatus of FIG.10 showing a distal attachment interface of the shaft coupled to a proximal end portion of the inflatable balloon. [0077] FIG.11B is a perspective view of the portion of the delivery apparatus of FIG.11A showing the crimp balloon over the shaft and a polymer reflowed over the inflatable balloon, shaft, and crimp balloon to seal them together. [0078] FIG.12 is a perspective view of a portion of the delivery apparatus of FIG.19 showing a proximal attachment interface of the shaft coupled to a distal end of the balloon shaft. [0079] FIG.13 is a perspective view of an exemplary delivery apparatus including a crimp balloon shaft having a body similar to the shaft of FIGS.7-9; however, the shaft shown in FIG.13 is longer and extends through the inflation balloon to a distal end of the delivery apparatus. [0080] FIG.14 is a perspective view of an exemplary delivery apparatus including a shaft extending along a crimp balloon of the delivery apparatus and coupled between a balloon shaft and an inflation balloon of the delivery apparatus, where the shaft comprises axially spaced rows of circumferential cuts that allow it to bend while also transferring torque from the balloon shaft to a distal end of the shaft. [0081] FIG.15 is a detail view of a portion of the shaft of FIG.14 in a flattened configuration, showing circumferentially extending rows of circumferential cuts that are spaced axially apart along the shaft, where each row comprises circumferential cuts spaced apart around the shaft. [0082] FIG.16 is a side view of the shaft of FIG.14 in a flattened configuration, the shaft having proximal and distal attachment interfaces that are configured to attach to the balloon shaft and inflation balloon of the delivery apparatus, respectively. [0083] FIG.17 is a perspective view of a portion of the delivery apparatus of FIG.14 showing the proximal and distal attachment interfaces of the shaft coupled to the balloon shaft and the inflation balloon of the delivery apparatus, respectively. [0084] FIG.18 is a side view of an exemplary crimp balloon shaft in a flattened configuration, wherein the shaft includes a first section that is configured to extend between a balloon shaft and inflation balloon of a delivery apparatus and comprises circumferential cuts and a second section that is configured to extend along the inflation balloon to a distal end of the delivery apparatus and comprises circumferentially extending puzzle cuts. [0085] FIG.19 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts. [0086] FIG.20 depicts an exemplary cut pattern for a crimp balloon shaft that comprises angled or spiral cuts. [0087] FIG.21 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with wider end portions. [0088] FIG.22 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with teardrop shaped end portions. [0089] FIG.23 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with hammerhead shaped end portions. [0090] FIG.24 depicts an exemplary cut pattern for a crimp balloon shaft that comprises circumferential cuts with wider end portions and triangular cuts protruding from the body of the cut. [0091] FIG.25 depicts an exemplary cut pattern for a crimp balloon shaft that comprises cuts having a wider body and narrower end portions. [0092] FIG.26 is a side view of an exemplary crimp balloon shaft for a delivery apparatus, the shaft comprising a body with a plurality of circumferentially extending rows of cuts and tubular end portions that each comprise a plurality of openings. [0093] FIG.27A is a perspective view of an exemplary crimp balloon shaft for a delivery apparatus, the shaft comprising a body with a plurality of circumferentially extending rows of cuts and tapered end portions that comprise a polymer. [0094] FIG.27B is a perspective view of the shaft of FIG.27A coupled to a balloon shaft and inflation balloon of an exemplary delivery apparatus. [0095] FIG.28 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with curved end portions. [0096] FIG.29 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with hooked end portions. [0097] FIG.30 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts with flared end portion that extend from a lattice structure of the attachment interface. [0098] FIG.31 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having an elongated slot. [0099] FIG.32 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having a relatively large opening at its distal end. [0100] FIG.33 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising spaced apart struts, each having a relatively large opening at its distal end and a wider leg portion. [0101] FIG.34 depicts an exemplary attachment interface for a crimp balloon shaft, the attachment interface comprising a tubular body with a plurality of openings. [0102] FIG.35 is a side view of an exemplary crimp balloon shaft comprising a plurality of interconnected struts forming alternating sections of lattice structure that provide bendability and radial compressibility to the shaft. [0103] FIG.36 is a flattened view of a portion of the shaft of FIG.35. [0104] FIG.37 is a perspective view of the shaft of FIG.35 connected to a balloon shaft of a delivery apparatus and bent at its bendable sections. [0105] FIG.38 is a view of an exemplary crimp balloon shaft in a flattened configuration, the shaft comprising struts that form a diamond lattice structure. [0106] FIG.39 is a view of an exemplary crimp balloon shaft in a flattened configuration, the shaft comprising alternating sections of first struts and second struts, the first struts configured to provide bendability to the shaft and the second struts configured to allow the shaft to compress circumferentially. [0107] FIG.40 is perspective view of an exemplary delivery apparatus including the shaft of FIG.39 coupled between a balloon shaft and inflation balloon. [0108] FIG.41 is a view of an exemplary crimp balloon shaft in a flattened configuration, the shaft comprising struts that form a diamond lattice structure and each strut comprising alternating cuts along its length which provides bendability to the shaft. [0109] FIG.42 is a detail view of a portion of struts of the shaft of FIG.41. [0110] FIG.43 is a view of an exemplary crimp balloon shaft in a flattened configuration, the shaft comprising a first section of struts forming a diamond lattice structure, second and third sections of alternating portions of longitudinally zig-zagging struts and circumferentially zig- zagging struts, and a fourth section of straight struts. [0111] FIG.44 is a perspective view of an exemplary delivery apparatus including the shaft of FIG.45 coupled between a balloon shaft and distal end of the delivery apparatus. [0112] FIG.45 is a schematic of a tube connecting a balloon shaft to an inflatable balloon of a delivery apparatus, and a crimp balloon arranged over the tube. [0113] FIG.46A is a perspective view of a polymeric shaft comprising a plurality of apertures, where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0114] FIG.46B is a perspective view of a metal shaft comprising a plurality of apertures, where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0115] FIG.46C is a perspective view of an exemplary puzzle shaft comprising a plurality of cuts where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0116] FIG.46D is a perspective view of a shaft comprising a braided mesh body, where the shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0117] FIG.46E is a perspective view of a coil spring shaft, where the coil spring shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0118] FIG.46F is a perspective view of a portion of a coiled wire shaft comprising multiple layers of coiled wire, where the coiled wire shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0119] FIG.46G is a perspective view of a portion of a coiled wire shaft comprising a single layer of coiled wire, where the coiled wire shaft is configured to be arranged underneath a crimp balloon in a prosthetic device delivery apparatus. [0120] FIG.47A is a perspective view of one end portion of the coil spring shaft of FIG.46E being arranged within a proximal leg of an inflation balloon of a delivery apparatus. [0121] FIG.47B is a perspective view of a crimp balloon being arranged over the coil spring shaft of FIG.47A. [0122] FIG.47C is a perspective view of another end portion of the coil spring shaft of FIG. 47B being arranged within a distal end of a balloon shaft of the delivery apparatus. [0123] FIG.47D is a perspective view of portion of the delivery apparatus of FIG.47C in a bent configuration. [0124] FIG.48 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus, the balloon having an elongated proximal leg comprising a plurality of through-holes along its length, where the proximal leg is configured to extend underneath a crimp balloon and toward a balloon shaft of the delivery apparatus. [0125] FIG.49 is a partial side view of the proximal leg of the balloon of FIG.45 showing a spiral arrangement of the holes in the proximal leg. [0126] FIG.50 is a partial side view of the proximal leg of FIG.50 with a crimp balloon arranged over the proximal leg and prosthetic valve crimped on the crimp balloon and proximal leg. [0127] FIG.51 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus, the balloon having an elongated proximal leg comprising a plurality of spaced apart recesses along its length, where the proximal leg is configured to extend to a balloon shaft of the delivery apparatus and receive a prosthetic device crimped thereon. [0128] FIG.52A is a cross-sectional view of a portion of the proximal leg of the balloon of FIG.51 depicting the recesses which create areas of high and low outer diameters along the length of the proximal leg. [0129] FIG.52B is a cross-sectional view of a portion of the proximal leg of the balloon of FIG.51 depicting the recesses which create areas of high and low outer diameters along the length of the proximal leg and a polymeric sleeve over an outer surface of the proximal leg. [0130] FIG.53 is a schematic view of an exemplary inflatable balloon for a prosthetic device delivery apparatus and a flexible shaft coupled to a proximal leg of the balloon, where the flexible shaft is configured to a balloon shaft of the delivery apparatus and receive a prosthetic device crimped thereon. [0131] FIG.54 is an exemplary longitudinal cross-section of a portion of the flexible shaft of FIG.53, according to an example where the shaft has inner corrugations extending from a central lumen of the flexible shaft. [0132] FIG.55A is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen and a plurality of offset lumens spaced apart from one another around the central lumen. [0133] FIG.55B is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen and a plurality of offset lumens spaced apart from one another around the central lumen. [0134] FIG.55C is an exemplary radial cross-section of the flexible shaft of FIG.53, according to an example where the shaft comprises a central lumen, a plurality of offset first lumens spaced apart from one another around the central lumen, and a plurality of offset second lumens spaced apart from one another around the first lumens. [0135] FIG.56A depicts an exemplary inflatable balloon in an at least partially inflated state, where the inflatable balloon includes a proximal leg comprising a plurality of longitudinal pleats. [0136] FIG.56B depicts the inflatable balloon of FIG.56A in a deflated state. [0137] FIG.57A is a cross-sectional view of a distal end portion of delivery apparatus, depicting a first braided layer of a balloon shaft of the delivery apparatus extending outward from a distal end of the balloon shaft to an inflatable balloon of the delivery apparatus, with a crimp balloon arranged around the portion of the first braided layer extending outward from the balloon shaft. [0138] FIG.57B is a side view of the distal end portion of the delivery apparatus of FIG.57A with the crimp balloon removed. [0139] FIG.57C is a side view of the distal end portion of the delivery apparatus of FIG.57B with the crimp balloon arranged over the first braided layer between the balloon shaft and the inflatable balloon. [0140] FIG.58 is a cross-sectional view of a distal end portion of delivery apparatus, depicting a first braided layer of a balloon shaft of the delivery apparatus extending outward from a distal end of the balloon shaft and tapering radially inward to an inner shaft of the delivery apparatus, where the first braided layer extends along an outer surface of the inner shaft to an inflatable balloon of the delivery apparatus. [0141] FIG.59A is a side view of the distal end portion of the delivery apparatus of FIG.58. [0142] FIG.59B is a side view of the distal end portion of the delivery apparatus of FIG.58 with a crimp balloon arranged around the first braided layer extending along the inner shaft. [0143] FIG.60 is a cross-sectional view of a distal end portion of delivery apparatus, depicting a stepped braided layer extending from within a balloon shaft of the delivery apparatus to an inner shaft of the delivery apparatus. [0144] FIG.61A depicts the stepped braided layer of FIG.60, which includes a larger diameter portion, a smaller diameter portion that extends over the inner shaft, and a stepped transition portion extending between the larger and smaller diameter portions. [0145] FIG.61B depicts the stepped braided layer of FIG.61A, with the larger diameter portion extending outward from a distal end of the balloon shaft. [0146] FIG.62 is a side view of a support structure for a crimp balloon comprising a plurality of longitudinally extending struts extending between two opposing rings of the of the support structure. [0147] FIG.63 is a side view of a support structure for a crimp balloon comprising a plurality of longitudinally extending struts held together with coiled wires around the crimp balloon. [0148] FIG.64 is a side schematic view of a balloon shaft comprising a main, larger diameter section extending from a handle of a delivery apparatus, a second larger diameter section extending from an inflatable balloon of the delivery apparatus, and a smaller diameter section extending between the main, larger diameter section and the second larger diameter section, where the smaller diameter section is configured to receive a prosthetic valve radially compressed directly thereon. [0149] FIG.65A is a side view of a delivery apparatus including the balloon shaft of FIG.64. [0150] FIG.65B is a portion of the balloon shaft of FIG.65A, depicting the smaller diameter section extending between the main, larger diameter section and the second larger diameter section. [0151] FIG.66 is a side schematic view of a balloon shaft comprising a main, larger diameter section extending from a handle of a delivery apparatus and a smaller diameter section extending between the main, larger diameter section and an inflatable balloon of the delivery apparatus, where the smaller diameter section is configured to receive a prosthetic valve radially compressed directly thereon. [0152] FIG.67 is a side perspective view of an exemplary balloon shaft for a delivery apparatus that comprises a metal tube with a plurality of cuts along its length that are configured to increase a flexibility of the tube, and a distal end portion configured to bond with a proximal end portion of an inflation balloon of the delivery apparatus. [0153] FIG.68 is a side perspective view of the distal end portion of the balloon shaft of FIG. 67 bonded to the inflation balloon. [0154] FIG.69 is a detail view of an exemplary pattern of cuts for the metal tube of FIG.67. [0155] FIG.70 is a side view of an exemplary shaft for a delivery apparatus that is configured to extend along a crimp balloon of the delivery apparatus and be coupled between a balloon shaft and an inflation balloon of the delivery apparatus at respective attachment interfaces of the shaft, where the shaft comprises a metal tube with openings cut therein. [0156] FIG.71 depicts the distal attachment interface of the shaft of FIG.70 in a flattened configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon. [0157] FIG.72A depicts the distal attachment interface of the shaft of FIG.70 in a radially collapsed configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon. [0158] FIG.72B depicts the distal attachment interface of the shaft of FIG.70 in a radially expanded (or flared) configuration, where the distal attachment interface is configured to couple to a proximal end portion of the inflation balloon. [0159] FIGS.73A-73D depict an exemplary process for manufacturing a distal attachment interface of a shaft for a delivery apparatus, such as the shaft of FIG.70, and flaring and bonding the distal attachment interface to an inflation balloon of the delivery apparatus. [0160] FIG.74A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with six rows of cells for even polymer bonding. [0161] FIG.74B depicts the attachment interface of FIG.74A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. [0162] FIG.75A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with seven rows of cells configured to provide a longer ramp when in a flared configuration. [0163] FIG.75B depicts the attachment interface of FIG.75A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. [0164] FIG.76A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with cells defining the free end of the attachment interface comprising cut outs that are configured such that the attachment interface is radially collapsable after flaring. [0165] FIG.76B depicts the attachment interface of FIG.76A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. [0166] FIG.77A depicts the proximal attachment interface of the shaft of FIG.70 in a radially collapsed configuration, where the proximal attachment interface is configured to couple to a distal end portion of a balloon shaft of a delivery apparatus. [0167] FIG.77B depicts the proximal attachment interface of the shaft of FIG.70 in a radially expanded (or flared) configuration, where the proximal attachment interface is configured to couple to a distal end portion of the balloon shaft of the delivery apparatus. [0168] FIGS.78A-78D depict an exemplary process for manufacturing a proximal attachment interface of a shaft for a delivery apparatus, such as the shaft of FIG.70, and flaring and bonding the proximal attachment interface to a balloon shaft of the delivery apparatus. [0169] FIG.79 depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a tapered lattice structure. [0170] FIG.80 depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure configured to prevent over expansion of the attachment interface. [0171] FIG.81A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure that is configured to flare more easily at its free end. [0172] FIG.81B depicts the attachment interface of FIG.81A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. [0173] FIG.82A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure with a first rows of cells at the free end that are each bisected by an axially extending strut. [0174] FIG.82B depicts the attachment interface of FIG.82A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. [0175] FIG.83A depicts an exemplary attachment interface for a crimp balloon shaft, such as the shaft of FIG.70, in a flattened configuration, where the attachment interface comprises a lattice structure that is configured to provide increased strength in the flared configuration. [0176] FIG.83B depicts the attachment interface of FIG.83A in flared configuration, where the free of the attachment interface is flared relative to a body of the shaft from which the attachment interface extends. DETAILED DESCRIPTION General Considerations [0177] For purposes of this description, certain aspects, advantages, and novel features of examples of this disclosure are described herein. The disclosed methods, apparatus, and systems should not be construed as being limiting in any way. Instead, the present disclosure is directed toward all novel and nonobvious features and aspects of the various disclosed examples, alone and in various combinations and sub-combinations with one another. The methods, apparatus, and systems are not limited to any specific aspect or feature or combination thereof, nor do the disclosed examples require that any one or more specific advantages be present or problems be solved. [0178] Although the operations of some of the disclosed examples are described in a particular, sequential order for convenient presentation, it should be understood that this manner of description encompasses rearrangement, unless a particular ordering is required by specific language set forth below. For example, operations described sequentially may in some cases be rearranged or performed concurrently. Moreover, for the sake of simplicity, the attached figures may not show the various ways in which the disclosed methods can be used in conjunction with other methods. Additionally, the description sometimes uses terms like “provide” or “achieve” to describe the disclosed methods. These terms are high-level abstractions of the actual operations that are performed. The actual operations that correspond to these terms may vary depending on the particular implementation and are readily discernible by one of ordinary skill in the art. [0179] As used in this application and in the claims, the singular forms “a,” “an,” and “the” include the plural forms unless the context clearly dictates otherwise. Additionally, the term “includes” means “comprises.” Further, the term “coupled” generally means physically, mechanically, chemically, magnetically, and/or electrically coupled or linked and does not exclude the presence of intermediate elements between the coupled or associated items absent specific contrary language. [0180] As used herein, the term “proximal” refers to a position, direction, or portion of a device that is closer to the user and further away from the implantation site. As used herein, the term “distal” refers to a position, direction, or portion of a device that is further away from the user and closer to the implantation site. Thus, for example, proximal motion of a device is motion of the device away from the implantation site and toward the user (e.g., out of the patient’s body), while distal motion of the device is motion of the device away from the user and toward the implantation site (e.g., into the patient’s body). The terms “longitudinal” and “axial” refer to an axis extending in the proximal and distal directions, unless otherwise expressly defined. [0181] As used herein, “e.g.” means “for example,” and “i.e.” means “that is.” Overview of the Disclosed Technology [0182] Prosthetic valves disclosed herein can be radially compressible and expandable between a radially compressed state and a radially expanded state. Thus, the prosthetic valves can be crimped on or retained by an implant delivery apparatus in the radially compressed state while being advanced through a patient’s vasculature on the delivery apparatus. The prosthetic valve can be expanded to the radially expanded state once the prosthetic valve reaches the implantation site. It is understood that the prosthetic valves disclosed herein may be used with a variety of implant delivery apparatuses and can be implanted via various delivery procedures, examples of which will be discussed in more detail later. [0183] As introduced above, it may be desirable to rotate a prosthetic valve (or other prosthetic device) mounted on a delivery apparatus in a radially compressed configuration. For example, prior to implantation, rotating the prosthetic valve with the delivery apparatus can allow for commissures of the prosthetic valve to be rotationally aligned with commissures of the native valve, thereby improving the performance of the implanted prosthetic heart valve, improving the function of the native anatomy, and/or enabling future interventional procedures that require access to coronary arteries or the valve leaflet. [0184] In some examples, for delivery of the prosthetic valve to a target implantation site, the prosthetic valve can be initially radially compressed and mounted at a location that is axially offset from the central section of the inflatable balloon, such as around a crimp balloon or relatively thin piece of tubing that connects a distal end of the balloon shaft of the delivery apparatus to a proximal end of the inflatable balloon. The crimp balloon gives the prosthetic valve a smaller-diameter inner member to mount onto, thereby reducing the overall crimp profile of the prosthetic valve and push forces and making it easier to navigate the prosthetic valve through a patient’s vasculature using the delivery apparatus. However, due to the crimp balloon being relatively thin and flimsy, rotation of the balloon shaft can result in unwanted twisting or deformation of the crimp balloon/tubing underneath the valve. This can cause unwanted movements of the prosthetic valve and/or twisting of other portions of the delivery apparatus. [0185] Thus, in some examples, a more rigid tube comprising a pattern of small cuts or a plurality of openings can be used to connect the balloon shaft to the inflatable balloon, and the prosthetic valve can be mounted thereon for delivery to an implantation site. In some examples, the more rigid tube can be a metal tube comprising a pattern of small cuts along its length (for example, laser cuts), or a pattern of open cells formed by struts of the metal tube, thereby allowing the tube to bend as the delivery apparatus navigates through bends in the patient’s vasculature, while also allowing the tube to effectively transfer torque from the balloon shaft to a proximal end of the inflatable balloon. [0186] In some examples, the more rigid tube can be an extension of a braided layer of the balloon shaft. [0187] In some examples, the more rigid tube can be an extension of the proximal leg of the inflatable balloon and can comprise holes, slits, cuts, or pleats. [0188] In some examples, the more rigid tube can be a polymeric shaft with axially extending holes or channels, or radially extending recesses, that provide the tube with flexibility, while still allowing it to transfer torque. [0189] FIG.1 is an exemplary prosthetic valve that can be mounted on and delivered by a delivery apparatus, such as the delivery apparatus shown in FIGS.2-5B. In some examples, the delivery apparatus comprises a crimp balloon that extends between a distal end of a balloon shaft of the delivery apparatus and a proximal end of the inflatable balloon of the delivery apparatus (as shown in FIG.5B). The crimp balloon can be configured to receive a prosthetic valve radially compressed thereon, as shown in FIG.5A. [0190] FIGS.6-18, 35-37, and 45-47C show various examples of shafts that can be mounted over or underneath a crimp balloon and transfer torque from the balloon shaft to a proximal end of the inflatable balloon which is attached to the shaft. The shafts can have various openings, cuts, slots, or the like, that provide flexibility to the shaft. [0191] FIGS.6-13 depict an exemplary crimp balloon shaft comprising a plurality of circumferentially extending, puzzle-shaped cuts that allow the shaft to compress axially, bend, and transfer torque. Another example of a puzzle-shaped cut design is shown in FIG. 46C. In some examples, the crimp balloon shaft extends between the balloon shaft and the proximal end of the inflatable balloon (as shown in FIG.6). In some examples, the crimp balloon shaft extends between the balloon shaft and through the inflatable balloon to a polymeric body mounted on a distal end portion of an inner shaft of the delivery apparatus (as shown in FIG.13). [0192] FIGS.14-17 depict an exemplary crimp balloon shaft comprising a plurality of circumferentially extending rows of circumferential cuts, where the rows are spaced axially apart along the shaft. FIGS.19-25 depict alternate shapes and arrangements of the cuts. [0193] FIG.18 depicts an exemplary crimp balloon shaft that comprises a first section with the puzzle-shaped cuts and a second section with the circumferential cuts, where the first section is configured to extend underneath the inflatable balloon of the delivery apparatus. [0194] Crimp balloon shafts can include attachment interfaces at their opposing ends that are configured to enhance coupling to the balloon shaft (at the proximal end) and either the inflatable balloon or the polymeric body of the delivery apparatus (at the distal end). FIGS. 26-34 depict various examples of attachment interfaces for any of the crimp balloon shafts described herein. [0195] FIG.70 depicts an exemplary crimp balloon shaft that comprises a metal and has opposing end portions defining first and second attachment interfaces and a body extending between the first and second attachment interfaces. The first attachment interface is configured to couple to a balloon shaft of the delivery apparatus and the second attachment interface is configured to couple to an inflation balloon of the delivery apparatus. The first and second attachment interfaces, various examples of which are depicted in FIGS.71-72B, FIGS.74A-77B, and FIGS.79-83B, comprise a lattice structure that is configured to be flared radially outward for attachment to the inflation balloon or balloon shaft. Exemplary processes for bonding the various attachment interfaces to either the inflation balloon of the balloon shaft are shown in FIGS.73A-73D and 78A-78D. [0196] FIGS.35-37 depict an exemplary balloon shaft comprising a plurality of interconnected struts forming alternating sections of lattice structure that provide bendability and radial compressibility to the shaft. [0197] FIGS.38-44 show various additional examples of crimp balloon shafts comprising a plurality of interconnected struts forming one or more lattice structures. [0198] In some examples, as shown in FIGS.48-52B and 56A-56B, the proximal end portion, or proximal leg, of the inflatable balloon can be extended to the balloon shaft and provide support for crimping a prosthetic valve thereon, while also being torqueable and bendable (due to holes, slits, pleats, or the like along the proximal end portion). [0199] In some examples, as shown in FIGS.53-55C, the crimp balloon can be replaced by a flexible, but torqueable, shaft that extends between the balloon shaft and the inflatable balloon. For example, the shaft can be polymeric and comprise a central lumen with additional, axially extending lumens, or recesses, surrounding the central lumen that provide flexibility to the shaft. [0200] In some examples, as shown in FIGS.64-66, the crimp balloon can be replaced by a smaller diameter segment of the balloon shaft, which is configured to receive a prosthetic valve in radially compressed configuration, directly thereon. [0201] In some examples, the balloon shaft and the crimp balloon can be replaced by a metal tube (for example, a hypotube) comprising a cut or slit pattern along at least a portion of its length that enables the tube to be both flexible (for example, bendable as it navigates bends in a patient’s vasculature) and torqueable, as shown in FIGS.67-69. The metal tube balloon shaft can extend from a proximal portion of the delivery apparatus to the inflatable balloon. In this way, a prosthetic vale can be mounted directly onto the metal tube balloon shaft. [0202] In some examples, as shown in FIGS.57A-61B, a braided tube layer, which is an extension of a braided layer of the balloon shaft, can extend from the balloon shaft to the inflatable balloon and be configured to transfer torque therebetween. A crimp balloon can be arranged around the braided tube layer. [0203] In some examples, as shown in FIGS.62 and 63, the crimp balloon can include a support structure arranged against or bonded to a surface of the crimp balloon. The support structure can comprise a plurality of spaced apart structs that provide rigidity to the crimp balloon and allow it to transfer torque, while still being bendable and able to at least partially inflate. [0204] In this way, the various shafts described here can provide support for crimping a prosthetic valve thereon (off the inflatable balloon), allow torque to be effectively transferred from the balloon shaft to a distal end of the shaft, and also be flexible to allow the shaft to navigate bends in a patient’s anatomy. Examples of the Disclosed Technology [0205] FIG.1 shows a prosthetic heart valve 100 (prosthetic valve), according to one example. Any of the prosthetic valves disclosed herein are adapted to be implanted in the native aortic annulus, although in other examples they can be adapted to be implanted in the other native annuluses of the heart (the pulmonary, mitral, and tricuspid valves). The disclosed prosthetic valves also can be implanted within vessels communicating with the heart, including a pulmonary artery (for replacing the function of a diseased pulmonary valve, or the superior vena cava or the inferior vena cava (for replacing the function of a diseased tricuspid valve) or various other veins, arteries and vessels of a patient. The disclosed prosthetic valves also can be implanted within a previously implanted prosthetic valve (which can be a prosthetic surgical valve or a prosthetic transcatheter heart valve) in a valve-in-valve procedure. [0206] In some examples, the disclosed prosthetic valves can be implanted within a docking or anchoring device that is implanted within a native heart valve or a vessel. For example, in one example, the disclosed prosthetic valves can be implanted within a docking device implanted within the pulmonary artery for replacing the function of a diseased pulmonary valve, such as disclosed in U.S. Publication No.2017/0231756, which is incorporated by reference herein. In another example, the disclosed prosthetic valves can be implanted within a docking device implanted within or at the native mitral valve, such as disclosed in PCT Publication No. WO2020/247907, which is incorporated herein by reference. In another example, the disclosed prosthetic valves can be implanted within a docking device implanted within the superior or inferior vena cava for replacing the function of a diseased tricuspid valve, such as disclosed in U.S. Publication No.2019/0000615, which is incorporated herein by reference. [0207] The prosthetic heart valve 100 can include a stent or frame 102, a valvular structure 104, and a perivalvular outer sealing member or outer skirt 106. The prosthetic heart valve 100 (and the frame 102) can have an inflow end 108 and an outflow end 110. The valvular structure 104 can be disposed on an interior of the frame 102 while the outer skirt 106 is disposed around an outer surface of the frame 102. [0208] The valvular structure 104 can comprise a plurality of leaflets 112 (for example, three leaflets, as shown in FIG.1), collectively forming a leaflet structure, which can be arranged to collapse in a tricuspid arrangement (or bicuspid arrangement in some examples). The leaflets 112 can be secured to one another at their adjacent sides (for example, commissure tabs) to form commissures 114 of the valvular structure 104. For example, each leaflet 112 can comprise opposing commissure tabs disposed on opposite sides of the leaflet 112 and a cusp edge portion extending between the opposing commissure tabs. The cusp edge portion of the leaflets 112 can have an undulating, curved scalloped shape, and can be secured (for example, by sutures) to an inner skirt 124 which is then secured to the frame 102 (such as with sutures 126). [0209] In some examples, the cusp edge portion of the leaflets 112 can be secured directly to the frame 102 (for example, by sutures). [0210] In some examples, the leaflets 112 can be formed of pericardial tissue (for example, bovine pericardial tissue), biocompatible synthetic materials, or various other suitable natural or synthetic materials as known in the art and described in U.S. Patent No.6,730,118, which is incorporated by reference herein. [0211] In some examples, each of the outer skirt 106 and the inner skirt 124 can be an annular skirt. In some instances, the outer skirt 106 and/or the inner skirt 124 can comprise one or more skirt portions that are connected together and/or individually connected to the frame 102. The skirts 106, 124 can comprise a fabric or polymeric material, such as ePTFE, PTFE, PET, TPU, UHMWPE, PEEK, PE, etc. In some instances, instead of having a relatively straight upper edge portion, as shown in FIG.1, the outer skirt 106 can have an undulating upper edge portion that extends along and is secured to the angled struts 134. Examples of such outer skirts, as well as various other outer skirts, that can be used with the frame 102 can be found in U.S. provisional patent application No.63/366,599 filed June 17, 2022, which is incorporated by reference herein. [0212] The frame 102 can be radially compressible and expandable between a radially compressed (or collapsed) configuration and a radially expanded configuration (the expanded configuration is shown in FIG.1). [0213] The frame 102 can be made of any of various suitable plastically-expandable materials (for example, stainless steel, etc.) or self-expanding materials (for example, Nitinol). When constructed of a plastically-expandable material, the frame^102^(and thus the valve^100) can be crimped to a radially compressed state on a delivery catheter and then expanded inside a patient by an inflatable balloon or equivalent expansion mechanism. When constructed of a self-expandable material, the frame^102^(and thus the valve^100) can be crimped to a radially compressed state and restrained in the compressed state by insertion into a sheath or equivalent mechanism of a delivery catheter. Once inside the body, the valve can be advanced from the delivery sheath, which allows the valve to expand to its functional size. [0214] Suitable plastically-expandable materials that can be used to form the frames disclosed herein (for example, the frame^102) include, metal alloys, polymers, or combinations thereof. Example metal alloys can comprise one or more of the following: nickel, cobalt, chromium, molybdenum, titanium, or other biocompatible metal. In some examples, the frame 102 can comprise stainless steel. In some examples, the frame 102 can comprise cobalt-chromium. In some examples, the frame 102 can comprise nickel-cobalt- chromium. In some examples, the frame^102 comprises a nickel-cobalt-chromium- molybdenum alloy, such as MP35N™ (tradename of SPS Technologies), which is equivalent to UNS R30035 (covered by ASTM F562-02). MP35N™/UNS R30035 comprises 35% nickel, 35% cobalt, 20% chromium, and 10% molybdenum, by weight. [0215] As shown in FIG.1, the frame 102 can comprise a plurality of interconnected struts 116 which form multiple rows of open cells 118 between the outflow end 110 and the inflow end 108 of the frame 102. In some examples, the frame 102 can comprise three rows of cells 118 with a first (upper in the orientation shown in FIG.1) row of cells 120 disposed at the outflow end 110. The first row of cells 120 comprises cells 118 that are elongated in an axial direction (relative to a central longitudinal axis 122 of the frame 102), as compared to cells 118 in the remaining rows of cells. For example, the cells 118 of the first row of cells 120 can have a longer axial length than cells 118 in the remaining rows of cells. [0216] In some examples, as shown in FIG.1, each row of cells comprises nine cells 118. Thus, in such examples, the frame 102 can be referred to as a nine-cell frame. [0217] In alternate examples, the frame 102 can comprise more than three rows of cells (for example, four or five) and/or more or less than nine cells per row. In some examples, the cells 118 in the first row of cells 120 may not be elongated compared to cells 118 in the remaining rows of cells of the frame 102. [0218] The interconnected struts 116 can include a plurality of angled struts 130 arranged in a plurality of rows of circumferentially extending rows of angled struts, with the rows being arrayed along the length of the frame 102 between the outflow end 110 and the inflow end 108. The interconnected struts 116 can also include a plurality of axially extending window struts 138 (or window strut portions) and a plurality of axial (or axially extending) struts 140. The axially extending window struts 138 (which can also be referred to as axial struts that include a commissure window) define commissure windows (for example, open windows) 142 that are spaced apart from one another around the frame 102, in a circumferential direction, and which are adapted to receive a pair of commissure tabs of a pair of adjacent leaflets 112 arranged into a commissure (for example, commissure 114). In some examples, the commissure windows 142 and/or the axially extending window struts 138 defining the commissure windows 142 can be referred to herein as commissure features or commissure supports, each commissure feature or support configured to receive and/or be secured to a pair of commissure tabs of a pair of adjacent leaflets. [0219] One or more (for example, two, as shown in FIG.1) axial struts 140 can be positioned between, in the circumferential direction, two commissure windows 142 formed by the window struts 138. Since the frame 102 can include fewer cells per row (for example, nine) and fewer axial struts 140 between each commissure window 142, as compared to some more traditional prosthetic heart valves, each cell 118 can have an increased width (in the circumferential direction), thereby providing a larger opening for blood flow and/or coronary access. [0220] Each axial strut 140 and each window strut 138 forms an axial side of two adjacent cells of the first row of cells 120. [0221] Commissure tabs 115 of adjacent leaflets 112 can be secured together to form commissures 114 (FIG.1). Each commissure 114 of the prosthetic heart valve 100 comprises two commissure tabs 115 paired together, one from each of two adjacent leaflets 112, and extending through a commissure window 142 of the frame 102. Each commissure 114 can be secured to the window struts 138 forming the commissure window 142. [0222] The cusp edge portion (for example, scallop edge) of each leaflet 112 can be secured to the frame 102 via one or more fasteners (for example, sutures). In some examples, the cusp edge portion of each leaflet 112 can be secured directly to the struts of the frame 102. [0223] In some examples, the cusp edge portion of the leaflets 112 can be secured to an inner skirt and the inner skirt can then be secured directly to the frame 102. [0224] Various methods for securing the leaflets 112 to a frame, such as the frame 102, are disclosed in U.S. provisional patent applications 63/278,922, filed November 12, 2021, and 63/300,302, filed January 18, 2022, both of which are incorporated by reference herein. [0225] The frame 102 can further comprise a plurality of apex regions 152 formed at the inflow end 108 and the outflow end 110, each apex region 152 extending and forming a junction between two angled struts 130 at the inflow end 108 or outflow end 110. As such, the apex regions 152 are spaced apart from one another, in a circumferential direction at the inflow end 108 and the outflow end 110. Additional details and examples of frames for prosthetic heart valves that include apex regions can be found in PCT Application No. PCT/US2022/025687, which is incorporated by reference herein. [0226] FIGS.2-5B show a delivery apparatus 200, according to an example, that can be used to implant an expandable prosthetic heart valve (for example, the prosthetic heart valve 100 of FIG.1). In some examples, the delivery apparatus 200 is specifically adapted for use in introducing a prosthetic valve into a heart. [0227] The delivery apparatus 200 generally includes a steerable guide catheter 214, and a balloon catheter 216 extending through the guide catheter 214. The guide catheter 214 an also be referred to as a flex catheter or a main catheter. The use of the term “main catheter” should be understood, however, to include flex or guide catheters, as well as other catheters or shafts that do not have the ability to flex or guide through a patient’s vasculature. [0228] The guide catheter 214 and the balloon catheter 216 in the illustrated example are adapted to slide longitudinally relative to each other to facilitate delivery and positioning of a prosthetic valve 212 (which may be the prosthetic valve 100 of FIG.1, in some examples) at an implantation site in a patient’s body, as described further below. [0229] The guide catheter 214 includes a handle portion 220 (as shown in FIGS.2-3B) and an elongated guide tube, or shaft, 222 extending from handle portion 220 (FIG.3A, 4, and 5). FIG.2 shows the delivery apparatus without the guide catheter shaft 222 for purposes of illustration. FIG.4 shows the guide catheter shaft 222 extending from the handle portion 220 over the balloon catheter. The balloon catheter 216 includes a proximal portion 224 (FIG.2) adjacent the handle portion 220 and an elongated shaft 226 (referred to herein as the balloon catheter shaft or balloon shaft) that extends from the proximal portion 224 and through handle portion 220 and guide catheter shaft 222 (FIGS.2, 4, and 5). [0230] The handle portion 220 can include a side arm 227 having an internal passage which fluidly communicates with a lumen defined by the handle portion 220. [0231] An inflatable balloon 228 is mounted at the distal end of balloon catheter 216. As shown in FIG.5A, the delivery apparatus 200 is configured to mount the prosthetic valve 212 in a crimped (radially compressed) state proximal to the balloon 228 for insertion of the delivery apparatus 200 and prosthetic valve 212 into a patient’s vasculature, which is described in detail in U.S. Publication No.2009/0281619, which is incorporated by reference herein. Because the prosthetic valve 212 is crimped at a location different from the location of balloon 228 (for example, in this case the prosthetic valve 212 is crimped proximal to balloon 228), the prosthetic valve 212 can be crimped to a lower profile than would be possible if prosthetic valve 212 was crimped on top of the balloon 228. This lower profile permits the user to more easily navigate the delivery apparatus (including crimped valve 212) through a patient’s vasculature to the treatment location. The lower profile of the crimped prosthetic valve is particularly helpful when navigating through portions of the patient’s vasculature which are particularly narrow, such as the iliac artery. The lower profile also allows for treatment of a wider population of patients. [0232] A nose cone 232 (FIG.54) (or nose cone) can be mounted at the distal end of the delivery apparatus 200 to facilitate advancement of the delivery apparatus 200 through the patient’s vasculature to the implantation site. In some instances, it may be useful to have nose cone 232 connected to a separate elongated shaft so that nose cone 232 can move independently of other elements of delivery apparatus 200. [0233] As can be seen in FIG.3A, the balloon catheter 216 can include an inner shaft 234 that extends from the proximal portion 224 and coaxially through the outer balloon catheter shaft 226 (which can also be referred to as an “outer shaft”) and the balloon 228. In some examples, the nose cone 232 can be mounted on a distal end portion of the inner shaft 234. [0234] In some examples, the nose cone 232 includes or is coupled to a distal shoulder 233 (which may be a polymeric body), which in turn is mounted on the distal end portion of the inner shaft 234, as shown in FIG.5B. [0235] In some examples, a mounting member 235 can be arranged around the inner shaft 234, within the balloon 228, to help secure a prosthetic valve on the balloon 228 once positioned there, as described herein (as shown in FIG.5B). [0236] Throughout the detailed description, the outer balloon catheter shaft 226 and equivalent shafts (e.g., shafts 326, 426, 756, and 792) are generally referred to as “balloon shafts” or “balloon catheter shafts”. The balloon 228 can be supported on a distal end portion of inner shaft 234 that extends outwardly from and distal to the outer shaft 226, with a proximal end portion 236 of the balloon 228 secured to the distal end of the outer shaft 226 (FIG.2). The outer diameter of inner shaft 234 is sized such that an annular space is defined between the inner shaft 234 and the outer shaft 226 along the entire length of the outer shaft 226. The proximal portion 224 of the balloon catheter can be formed with a fluid passageway (not shown) that is fluidly connectable to a fluid source (e.g., saline or another inflation fluid) for inflating the balloon. The fluid passageway is in fluid communication with the annular space between inner shaft 234 and outer shaft 226 such that fluid from the fluid source can flow through fluid passageway, through the space between the shafts, and into balloon 228 to inflate the same and deploy prosthetic valve 212. [0237] The proximal portion 224 also defines an inner lumen that is in communication with a lumen 238 of the inner shaft 234 that is sized to receive guide wire (not shown) that can extend coaxially through the inner shaft 234 and the nose cone 232. [0238] The inner shaft 234 and balloon catheter shaft 226 (or outer shaft) of the balloon catheter can be formed from any of various suitable materials, such as nylon, braided stainless steel wires, or a polyether block amide (commercially available as Pebax®). The shafts 226, 234 can have longitudinal sections formed from different materials in order to vary the flexibility of the shafts along their lengths. The inner shaft 234 can have an inner liner or layer formed of Teflon® to minimize sliding friction with a guide wire. [0239] The distal end portion of the guide catheter shaft 222 comprises a steerable section 268 (FIG.4), the curvature of which can be adjusted by the operator to assist in guiding the apparatus through the patient’s vasculature, and particularly the aortic arch. The handle portion 220 (or handle 220) in the illustrated example comprises a distal handle portion 246 and a proximal handle portion 248. The distal handle portion 246 functions as a mechanism for adjusting the curvature of the distal end portion of the guide catheter shaft 222 and, in some examples, as a flex indicating device that allows a user to measure the relative amount of flex of the distal end of the guide catheter shaft 222. In some examples, the flex indicating device can provide a visual and tactile response at the handle the device, which provides a user with an immediate and direct way to determine the amount of flex of the distal end of the catheter. [0240] The distal handle portion 246 can be operatively connected to the steerable section 268 and functions as an adjustment mechanism to permit operator adjustment of the curvature of the steerable section via manual adjustment of the handle portion. In some examples, the handle portion 246 can comprise a flex activating member 250, an indicator pin 252, and a cylindrical main body, or housing 254. As shown in FIGS.3A and 3B, the flex activating member 250 comprises an adjustment knob 256 and a shaft 258 extending proximally from the knob into the housing 254. A proximal end portion of the guide catheter shaft 222 extends into and is fixed within the central lumen of the housing 254. An inner sleeve 270 surrounds a portion of the guide catheter shaft 222 inside the housing 254. A threaded slide nut 272 is disposed on and is slidable relative to the sleeve 270. The slide nut 272 is formed with external threads that mate with internal threads 260 of the shaft 258. [0241] The slide nut 272 can be formed with two slots formed on the inner surface of the nut and extending the length thereof. The sleeve270 can be formed with longitudinally extending slots that are aligned with the slots of the slide nut 272 when the slide nut is placed on the sleeve. Disposed in each slot is a respective elongated nut guide, which can be in the form of an elongated rod or pin 276. The pins 276 extend radially into respective slots in the slide nut 272 to prevent rotation of the slide nut 272 relative to the sleeve 270. By virtue of this arrangement, rotation of the adjustment knob 256 (either clockwise or counterclockwise) causes the slide nut 272 to move longitudinally relative to the sleeve 270 in the directions indicated by double-headed arrow 274 (FIG.3B). [0242] One or more pull wires 278 (FIG.3A) couple the adjustment knob 256 to the steerable section 268 to adjust the curvature of the steerable section upon rotation of the adjustment knob. For example, the proximal end portion of the pull wire 278 can extend into and can be secured to a retaining pin, such as by crimping the pin around the proximal end of the pull wire, which pin is disposed in a slot in the slide nut 272. The pull wire can extend from the pin, through the slot in the slide nut, a slot in the sleeve 270, and into and through a pull wire lumen in the shaft 222. The distal end portion of the pull wire is secured to the distal end portion of the steerable section 268. [0243] In some examples, the pin, which retains the proximal end of the pull wire 278, is captured in the slot in the slide nut 272. Hence, when the adjustment knob 256 is rotated to move the slide nut 272 in the proximal direction, the pull wire also is moved in the proximal direction. The pull wire pulls the distal end of the steerable section 268 back toward the handle portion, thereby bending the steerable section and reducing its radius of curvature. The friction between the adjustment knob 256 and the slide nut 272 is sufficient to hold the pull wire taut, thus preserving the shape of the bend in the steerable section if the operator releases the adjustment knob 256. When the adjustment knob 256 is rotated in the opposite direction to move the slide nut 272 in the distal direction, tension in the pull wire is released. The resiliency of the steerable section 268 causes the steerable to return its normal, non- deflected shape as tension on the pull wire is decreased. Because the pull wire is not fixedly secured to the slide nut 272 (the pin can move within the slot in the nut), movement of the slide nut in the distal direction does not push on the end of the pull wire, causing it to buckle. Instead, the pin is allowed to float within the slot of the slide nut 272 when the knob 256 is adjusted to reduce tension in the pull wire, preventing buckling of the pull wire. [0244] In some examples, the steerable section 268 in its non-deflected shape is slightly curved and in its fully curved position, the steerable section generally conforms to the shape of the aortic arch. In other embodiments, the steerable section can be substantially straight in its non-deflected position. [0245] The distal handle portion 246 can have other configurations that are adapted to adjust the curvature of the steerable section 268. One such alternative handle configuration is shown in U.S. Publication No.2007/0005131, which is incorporated by reference herein in its entirety. Additional details relating to the steerable section and handle configuration discussed above can be found in U.S. Patent Publication No. US2008/0065011 and US2013/0030519, which are incorporated by reference herein in their entireties. [0246] The shaft 258 can also include an externally threaded surface portion 262. As shown in FIG.3B, a base portion 264 of the indicator pin 252 mates with the externally threaded surface portion 262 of the shaft 258. The shaft 258 extends into the housing 254 and the indicator pin 252 is trapped between the externally threaded surface portion 262 and the housing 254, with a portion of the indicator pin 252 extending into a longitudinal slot 266 of the handle. As the knob 256 rotated to increase the curvature of the distal end of the guide catheter shaft 222, the indicator pin 252 tracks the external threaded portion 262 of the flex activating member and moves in the proximal direction inside of the slot 266. The greater the amount of rotation of the knob 256, the further indicator pin 252 moves towards the proximal end of the proximal handle portion 246. Conversely, rotating the knob 256 in the opposite direction decreases the curvature of the distal end of the guide catheter shaft 222 (i.e., straightens the guide catheter shaft) and causes corresponding movement of the indicator pin 252 toward the distal end of the distal handle portion 246. [0247] The outer surface of the housing 254 of the distal handle portion 246 can include visual indicia adjacent the slot 266 that indicate the amount of flex of the distal end of the guide catheter shaft 222, based on the position of the indicator pin 252 relative to the visual indicia. Such indicia can identify the amount of flex in any of a variety of manners. For example, the outer surface of the housing 254 can include a series of numbers (for example, 0 to 10) adjacent the slot that indicate the amount of curvature of the guide catheter shaft 222 based on the position of the indicator pin 252 relative to the number scale. [0248] As described above, when the delivery apparatus is introduced into the vasculature of the patient, a crimped (or radially compressed) prosthetic valve 212 is positioned proximal to the balloon 228 (FIG.5A). In some examples, as shown in FIG.5B, the delivery apparatus 200 includes a relatively thin piece of tubing or a sleeve, which can be referred to herein as a crimp balloon 225 (the crimp balloon 225 is also depicted schematically in FIG.45), that couples a distal end of the balloon catheter shaft 226 to a proximal end (which may include and be referred to as a proximal leg 231) of the inflatable balloon 228. Examples of such an arrangement are described below with reference to FIGS.6-44. The crimp balloon 225 can be made of any of various polymers traditionally used for forming medical balloons (e.g., nylon, Pebax, etc.). In some examples, the crimp balloon 225 and the balloon 228 are made of the same material. In some examples, the crimp balloon 225 can be at least partially inflated with an inflation fluid to partially expand a prosthetic valve mounted thereon prior to repositioning the prosthetic valve onto the balloon 228, as further described below. [0249] Prior to expansion of the balloon 228 and deployment of prosthetic valve 212 at the treatment site, the prosthetic valve 212 is moved axially relative to the balloon (or vice versa) to position the crimped prosthetic valve on the balloon 228 for deploying (expanding) the prosthetic valve. For example, as discussed below, the proximal handle portion 248 can serve as an adjustment device that can be used to move the balloon 228 proximally into position within the frame of prosthetic valve 212, and further to accurately position the balloon and the prosthetic valve at the desired deployment location. [0250] As shown in FIGS.3A and 3B, the proximal handle portion 248 comprises an outer housing 280 and an adjustment mechanism 282. The adjustment mechanism 282, which is configured to adjust the axial position of the balloon catheter shaft 226 relative to the guide catheter shaft 222, comprises an adjustment knob 284 and a shaft 286 extending distally into the housing 280. Mounted within the housing 280 on the balloon catheter shaft 226 is an inner support 288, which in turn mounts an inner shaft 290 (also referred to as a slider or sliding mechanism). The inner shaft 290 has a distal end portion 292 formed with external threads that mate with internal threads 294 that extend along the inner surface of the adjustment mechanism 282. The inner shaft 290 further includes a proximal end portion 296 that mounts a securement mechanism 298, which is configured to retain the position of the balloon catheter shaft 226 relative to the proximal handle portion 248 for use of the adjustment mechanism 282, as further described below. The inner shaft 290 can be coupled to the inner support 288 such that rotation of shaft 286 causes the inner shaft 290 to move axially within the handle. For example, the inner support 288 can have an axially extending rod or rail that extends into slot formed in the inner surface of the inner shaft 290. The rod or rail prevents rotation of the inner shaft 290 but allows it to move axially upon rotation of the shaft 286. [0251] The securement mechanism 298 includes internal threads that mate with external threads of the proximal end portion 296 of the inner shaft. Mounted within the proximal end portion 296 on the balloon catheter shaft 226 is a pusher element 210 and a shaft engagement member in the form of a collet 202. The collet 202 is configured to be manipulated by the securement mechanism between a first state in which collet allows the balloon catheter shaft to be moved freely in the longitudinal and rotational directions and a second state in which the collet frictionally engages the balloon catheter shaft and prevents rotational and longitudinal movement of the balloon catheter shaft relative to the inner shaft 290. [0252] As noted above, the securement mechanism 298 is operable to restrain movement of the balloon catheter shaft 226 (in the axial and rotational directions) relative to the proximal handle portion 248. In some examples, the securement mechanism 298 is movable between a proximal position (shown in FIGS.3A and 3B) and a distal position closer to the adjacent end of the knob 284. In the proximal position, the collet 202 applies little, if any, force against the balloon catheter shaft 226, which can slide freely relative to the collet 202, the entire handle portion 220, and the guide catheter shaft 222. When the securement mechanism 298 is rotated so as to move to its distal position closer to knob 284, the securement mechanism urges pusher element 210 against the proximal end of the collet 202. The holding force of the collet 202 against the balloon catheter shaft 226 locks the balloon catheter shaft 226 relative to the inner shaft 290. In the locked position, rotation of the adjustment knob 284 causes the inner shaft 290, the inner shaft 234, and the balloon catheter shaft 226 to move axially relative to the guide catheter shaft 222 (either in the proximal or distal direction, depending on the direction the knob 284 is rotated). [0253] The adjustment knob 284 can be utilized to position the prosthetic valve 212 on the balloon 228 and/or once the prosthetic valve 212 is on the balloon 228, to position the prosthetic valve and the balloon at the desired deployment site within the native valve annulus. [0254] One exemplary method for implanting the prosthetic valve 212 in the native aortic valve is as follows. The prosthetic valve 212 initially can be crimped on a mounting region (FIG.5A) of the balloon catheter shaft 226 immediately adjacent the proximal end of the balloon 228 (such as on a crimp balloon). The proximal end of the prosthetic valve can abut the distal end 223 of the guide catheter shaft 222 (FIG.5A), which keeps the prosthetic valve in place on the balloon catheter shaft or crimp balloon as the delivery apparatus and prosthetic valve are inserted through an introducer sheath. The prosthetic valve 212 can be delivered in a transfemoral procedure by first inserting an introducer sheath into the femoral artery and pushing the delivery apparatus through the introducer sheath into the patient’s vasculature. [0255] After the prosthetic valve 212 is advanced through the narrowest portions of the patient’s vasculature (e.g., the iliac artery), the prosthetic valve 212 can be moved onto the balloon 228. For example, a convenient location for moving the prosthetic valve onto the balloon is the descending aorta. The prosthetic valve can be moved onto the balloon, for example, by holding the handle portion 246 steady (which retains the guide catheter shaft 222 in place) and moving the balloon catheter shaft 226 in the proximal direction relative to the guide catheter shaft 222. As the balloon catheter shaft is moved in the proximal direction, the distal end 223 of the guide catheter shaft pushes against the prosthetic valve, allowing the balloon 228 to be moved proximally through the prosthetic valve in order to center the prosthetic valve on the balloon 228. The balloon catheter shaft can include one or more radiopaque markers to assist the user in positioning the prosthetic valve at the desired location on the balloon. The balloon catheter shaft 226 can be moved in the proximal direction by simply sliding/pulling the balloon catheter shaft in the proximal direction if the securement mechanism 298 is not engaged to retain the shaft 226. For more precise control of the shaft 226, the securement mechanism 298 can be engaged to retain the shaft 226, in which case the adjustment knob 284 is rotated to effect movement of the shaft 226 and the balloon 228. The axial position of the balloon shaft 226 can be fixed relative to the inner shaft 234, such that axial movement of the balloon shaft 226 relative to the outer shaft 222 produces axial movement of the balloon shaft 226, the inner shaft 234, and the balloon 228 relative to the outer shaft 222. In lieu of or in addition to moving the balloon shaft 226, the inner shaft 234, and the balloon 228 proximally relative to the outer shaft 222, repositioning of the prosthetic valve can be accomplished by moving the outer shaft 222 distally relative to the balloon shaft 226, the inner shaft 234, and the balloon 228. [0256] In some examples, prior to repositioning the prosthetic valve, the crimp balloon 225 can be partially inflated to slightly expand the prosthetic valve, which facilitates sliding of the prosthetic valve relative to the balloon 228. [0257] Further details on the delivery apparatus 200 can be found in U.S. Patent No. 9,339,384, which is incorporated by reference herein in its entirety. [0258] As introduced above, it may be desirable to rotate a prosthetic valve mounted on a delivery apparatus in a radially compressed configuration in order to achieve a desired circumferential or rotational orientation relative to the native anatomy, upon deployment of the prosthetic valve. In some examples, rotating the prosthetic valve with the delivery apparatus can allow for commissures of the prosthetic valve to be rotationally aligned with commissures of the native valve, thereby improving the performance of the implanted prosthetic heart valve. [0259] In some examples, this rotation may occur after the prosthetic valve is moved from the crimp balloon 225 onto the inflatable balloon 228. [0260] In some examples, this rotation may occur while the prosthetic valve is mounted off the inflatable balloon of the delivery apparatus (for example, as shown in FIG.5A), such as on the crimp balloon 225. [0261] However, due to the relatively thin construction of the crimp balloon, torque may not be effectively transferred from the balloon shaft to more distal portions of the delivery apparatus, such as the distal end of the crimp balloon, and to the inflatable balloon (and the prosthetic valve mounted thereon, for example). Further, in some examples, unwanted twisting or deformation of portions of the delivery apparatus can occur when attempting to rotate the prosthetic valve by transferring torque through the crimp balloon, thereby causing bending of the crimp balloon and unwanted movement of the prosthetic valve. [0262] Thus, in some examples, as shown schematically in FIG.45, a more rigid tube 229 (which can also be referred to herein as a shaft) comprising a plurality of openings or relatively small cuts can be used to connect the balloon shaft 226 to the inflatable balloon 228, and the prosthetic valve can be mounted thereon for delivery to an implantation site. Such a tube 229 can be configured to bend as the delivery apparatus navigates through bends in the patient’s vasculature (for example, by flexing the distal end portion of the delivery apparatus), while also allowing torque to be effectively transferred from the balloon shaft 226 to the distal end of the crimp balloon 225 and/or to more distal portions of the delivery apparatus, such as to the inflatable balloon 228 and the distal shoulder of the delivery apparatus. [0263] In some examples, the tube 229 can be a separate component mounted over (as shown in the example of FIG.45) or underneath the crimp balloon 225. [0264] In some examples, the tube 229 can be a separate component that replaces the crimp balloon. In some examples, the tube 229 can be an extension of a proximal leg (or proximal end portion) of the inflation balloon, that has increased rigidity compared to a portion of the inflation balloon that is inflatable when filled with inflation balloon and is used to deploy the prosthetic valve. [0265] FIGS.6-47D show examples of various shafts or tubes that can extend between and be used to couple a distal end of a balloon shaft (or balloon catheter shaft, such as balloon catheter shaft 226 of delivery apparatus 200) to a proximal end portion of an inflatable balloon of the delivery apparatus (such as the balloon 228 of the delivery apparatus 200). In some examples, the shafts or tubes can extend from the distal end of the balloon shaft to a proximal end portion of the inflatable balloon, or to a distal shoulder or nose cone mounted on an inner shaft of the delivery apparatus (such as the inner shaft 234 of delivery apparatus 200), thereby effectively transferring torque from the balloon shaft to the distal end of the crimp balloon (and thus to the inflatable balloon). The crimp balloon of the delivery apparatus can either extend over or underneath the various shafts or tubes described below, and thus the shafts described below can be referred to “crimp balloon shafts” (or tubes). In this way, the shafts or tubes can provide additional support for a prosthetic valve mounted therearound and effective torque transfer from the balloon shaft to the distal end of the crimp balloon shaft and the inflatable balloon. [0266] In some examples, the tubes or shafts described below can comprise metal, such as stainless steel or Nitinol. In some examples, the shafts are relatively thin metal tubes (for example, a hypotube) that are cut (for example, laser cut) to form the plurality of openings or cuts (for example, as shown in FIGS.6-27B and 46B-46D). In some examples, the tubes or shafts comprise a plurality of struts forming various lattice structures (for example, as shown in FIGS.35-44). In some examples, the tubes or shafts comprise a polymer and/or can be an extension of a proximal leg of the inflatable balloon and have holes or cuts that allow it to bend while also transferrin torque (for example, as shown in FIGS.46A and 48-52B). In some examples, the tubes or shaft can comprise a polymer and have multiple axially extending lumens, including a central lumen such that the shaft can replace the crimp balloon. [0267] The patterns of the cuts or openings in the tubes or shafts described herein can be specified to give the shaft flexibility, in some cases compressibility, and allow for secure attachment to the balloon shaft and the inflation balloon. Further, in some examples, the cuts or openings in the tubes or shafts described herein can extend in a radial direction, through at least a portion of a thickness of the shafts (as defined between a radially outward facing surface and radially inward facing surface of the shaft). [0268] FIGS.6-12 show a relatively rigid tube or shaft 300 (which can also be referred to herein as a crimp balloon shaft) comprising a plurality of circumferentially extending rows 302 of cuts that are spaced axially apart from one another along a body 305 of the shaft 300. In some examples, each row 302 of cuts is a continuous cut 304 that extends around a circumference of the shaft 300 and forms a plurality of interconnecting rings 310 (or circumferentially extension sections) with spaced apart projections 306 on both sides of the cut 304 (with notches or spaces 308 defined between adjacent projections), where the projections 306 on opposite sides of the cut 304 alternate with one another such that the projections 306 on the opposite sides of the cut 304 fit together like puzzle pieces with a gap therebetween (the gap formed by a width of the cut 304). In this way, in some examples, the cut pattern of the shaft 300 can be referred to as a “puzzle cut” pattern. [0269] For example, each projection 306 on a first side of the cut fits within a space 308 formed between two adjacent projections 306 on a second side of the cut 304, the second side being opposite the first side. [0270] The notches or spaces 308 are configured to receive the projections 306 of adjacent circumferentially extending sections 310 (or rings). [0271] In some examples, the notches 308 are sized slightly larger than the projections 306 (that is, the projections 306 are not tightly received within the notches 308), which can allow the shaft 300 to compress axially (in an axial direction defined along a central longitudinal axis of the shaft and delivery apparatus), which is beneficial during inflation of the inflatable balloon (as discussed herein). [0272] A width of the cut 304 (or a size of the gap formed between adjacent sections of the shaft 300) can vary based on a desired flexibility of the shaft 300. For example, as the width of the cuts 304 increases, the shaft 300 can compress more axially and/or bend more; however, there may also be more torque delay between the balloon shaft and the inflation balloon. [0273] In some examples, a number of cuts 304, or the spacing between adjacent circumferentially extending cuts 304 can also vary based on a desired flexibility of the shaft 300. For example, a smaller spacing between adjacent cuts 304, can result in more cuts 304 and smoother bending of the shaft 300. In contrast, larger spaces between the cuts 304 can result in greater overall bendability of the shaft 300. In some examples, the projections 306 can be received within the notches 308 without any clearance or space between the adjacent surfaces of the projections and the notches. [0274] As introduced above, in some examples, the shaft 300 comprises metal, such as stainless steel. [0275] FIG.6 shows an exemplary delivery apparatus 320 including the shaft 300 coupled between the balloon shaft 326 and the inflation balloon 328 (which may also be referred to herein as an “inflatable balloon”). The delivery apparatus 320 can be the same or similar to the delivery apparatus 200, as described above, except for the inclusion of the shaft 300 underneath or over the crimp balloon 330. For example, the delivery apparatus 320 comprises a balloon shaft 326 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 320 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis 322 of the delivery apparatus 320. The delivery apparatus further comprises an inner shaft 334 extending through the balloon shaft 326 to a polymeric body mounted on the distal end of the inner shaft 334. The polymeric body can be a distal shoulder 336 and nose cone 332, as shown in FIG.6. In some examples, the distal shoulder 336 and nose cone 332 can be formed (for example, molded together) as one piece. [0276] In some examples, as shown in FIG.6, the crimp balloon 330 extends over (and surrounds) the shaft 300 and extends distally from the balloon shaft 326 to the inflation balloon 328. Further, the shaft 300 extends over a portion of the inner shaft 334 (the portion extending past the distal end of the balloon shaft 326 and the proximal end of the inflation balloon 328). [0277] In some examples, a first end (or proximal end) of the shaft 300 comprises a first attachment interface 312 and an opposite, second end (or distal end) of the shaft 300 comprises a second attachment interface 314. The first attachment interface 312 is configured to couple to the distal end of the balloon shaft 326, as shown in FIGS.10 and 12. The second attachment interface 314 is configured to couple to a proximal end portion, which may include proximal legs in some examples, of the inflation balloon 328, as shown in FIGS. 11A and 11B. [0278] In some examples, the first attachment interface 312 comprises a plurality of proximal struts 316 that are spaced apart around the first end and of the shaft 300 (as shown in FIGS.9, 10, and 12). Each proximal strut 316 can flare outward from the body of the shaft 300 and spiral along the distal end of the balloon shaft (as shown in FIGS.10 and 12). Each proximal strut 316 can be clamped onto an outer surface of the distal end of the balloon shaft 326, as shown in FIG.12. [0279] In some examples, the proximal struts 316 are secured or bonded to the outer surface of the distal end of the balloon shaft 326 by reflowing a polymer over the struts 316 and the distal end of the balloon shaft 326. [0280] In some examples, the proximal struts 316 are secured or bonded to the outer surface of the distal end of the balloon shaft 326 by an adhesive, tape, welding, or other fasteners. [0281] In some examples, each proximal strut 316 includes an aperture 317 in its proximal end that connects to the body 305 of the shaft 300, as shown in FIG.8. The aperture 317 is configured to provide strain relief to the proximal strut 316. In some examples, the aperture 317 looks like a star with four or more slits extending from the central opening of the aperture 317. [0282] Additional examples of a first attachment interface for the shaft 300 or the other shafts described herein is shown in FIGS.26, 27A, 30, 32, 33, and 34 (as described further below), any of which can replace the first attachment interface 312. [0283] In some examples, the second attachment interface 314 comprises a plurality of axially extending struts 318 that are spaced circumferentially apart around the second end. In some examples, each axially extending strut 318 has an arrow-shaped head 319 (or tip) or other flared end portion at its distal end (as shown in FIG.9). [0284] In some examples, the proximal end portion or legs of the inflation balloon 328 comprises a plurality of holes 338. Each arrow-shaped head 319 (or flared end portion) of each axially extending strut 318 can be inserted into a respective hole 338 to couple the second end of the shaft 300 to the proximal end portion of the inflation balloon 328 (as shown in FIG.11A). [0285] As shown in FIG.8, in some examples, each strut 318 includes an aperture 321 in its proximal end that connects to the body 305 of the shaft 300. The aperture 321 is configured to provide strain relief to the strut 318. The apertures 321 can have various shapes, such as diamond-shaped (as shown in FIG.8), square, star-shaped, circular, triangular, or the like. In some examples, the diamond-shaped apertures 321 can allow the second attachment interface 314 to form a continuous ring shape for better mating with the proximal leg of the inflation balloon 328. [0286] Additional examples of a second attachment interface for the shaft 300 or the other shafts described herein is shown in FIGS.28, 29, 31, 79A-82B, and 83B (as described further below), any of which can replace the second attachment interface 314. [0287] In some examples, as shown in FIG.11B, the proximal end portion of the inflation balloon 328 (which may include legs 340) and the second end of the shaft 300 are bonded together by a polymer reflowed over the arrow-shaped heads 319 of the struts 318 coupled to the holes 338 of the inflation balloon 328. In some examples, the polymer is also reflowed over the crimp balloon 330, as shown in FIG.11B, thereby securely bonding the proximal end portion of the inflation balloon 328, the distal end of the crimp balloon 330, and the second (or distal) end of the shaft 300 together. In this way, a fluid seal can be created such that inflation fluid passing through a space between an outer surface of the inner shaft 334 and the inner surface of the crimp balloon 330 is fluidly connected to an interior of the inflation balloon 328. Other techniques and/or mechanisms can be used to secure the balloon 328 to the second attachment interface 314, such as an adhesive, welding, tape, and/or mechanical fasteners. [0288] FIG.13 depicts the delivery apparatus 320 including a shaft 350 that is similar to the shaft 300 described above (for example, it has the same body 305). However, in the example of FIG.13, the shaft 350 is longer and extends over the inner shaft 334 and through the inflation balloon 328, to a distal end of the delivery apparatus 320. In some examples, as shown in FIG.13, the shaft 350 extends all the way to the distal shoulder 336 of the delivery apparatus 320. It should be noted that although a covering element or sleeve 335 (such as a polymer or tape) is covering the distal end of the shaft 350 in FIG.13, the distal end of the shaft 300 can extend all the way to the proximal end of the distal shoulder 336. [0289] In some examples, the shaft 350 is the same as shown in FIGS.7-9, except is longer (has a longer body 305) and the second attachment interface 314 is configured to couple to the distal shoulder. [0290] For example, the second attachment interface 314 can be a blunt end portion or an end of one of the sections of the body of the shaft 350 (for example, as shown in FIG.18). In some examples, the second attachment interface 314 can be any of the attachment interfaces described herein (such as any of those shown in FIGS.26-31). [0291] In some examples, the second attachment interface 314 at the distal end of the shaft 350 is overmolded into the distal shoulder 336. [0292] Assembly of the longer shaft 350 shown in FIG.13 with the rest of the delivery apparatus 320 can be easier than the shorter shaft 300 that couples to the proximal end portion of the inflation balloon 328. However, due to its longer length, the longer shaft 350 that couples to the distal shoulder 336 may have increased torque delay compared to the shorter version of the shaft 300. [0293] When the inflation balloon 328 inflates (for example, to deploy the prosthetic valve at an implantation site), axial foreshortening of the delivery apparatus 320 occurs in the region of the inflation balloon 328. The puzzle cuts 304 of the shaft 350 allow the portion of the shaft 350 underneath the inflation balloon 328 to compress axially. The width of the cuts 304, and thus the spacing between the sections 310, can be varied and specified based on the properties of the inflation balloon 328 and the expected amount of axial foreshortening during inflation of the inflation balloon 328. [0294] For example, if the width of the cuts 304 and the spacing between the sections 310 is too large, there can be more torque delay when rotating the balloon shaft 326. Conversely, if the width of the cuts 304 and the spacing between the sections 310 is too small, the shaft 350 may not foreshorten enough during expansion of the inflation balloon 328 (which may limit the expansion of the inflation balloon 328). Thus, the configurations of the puzzle cuts 304 can be adapted for the properties of the inflation balloon 328. [0295] FIGS.14-17 show a relatively rigid tube or shaft 400 (which can also be referred to herein as a crimp balloon shaft) comprising a plurality of circumferentially extending rows 402 of cuts that are spaced axially apart from one another along a body 405 of the shaft 400. The shaft 400 is incompressible in the axial direction and is configured to extend from a balloon shaft to an inflation balloon of a delivery apparatus, such as in the exemplary delivery apparatus 420 shown in FIG.14 (as described further below). A portion of the shaft 400 that shows the cuts in detail is shown in FIG.15. FIG.15 shows the shaft 400 with a first type of attachment interface at its distal end, while FIG.16 shows a flattened view of the entire shaft 400 having a second type of attachment interface at its distal end and another attachment interface at its proximal end. FIG.17 shows a more detailed view of the shaft 400 at its attachment interfaces coupling to the balloon shaft and inflation balloon of the delivery apparatus 420. [0296] Turning first to FIGS.15 and 16, in some examples, each row 402 of cuts comprises a plurality of individual cuts 404 that are spaced circumferentially apart around the shaft 400. Each individual cut 404 is a circumferential cut (extending in the circumferential direction and arranged perpendicular to a central longitudinal axis of the shaft 400. [0297] In some examples, one or more of the cuts 404 extend through a portion of a total thickness of the shaft 400 (where the thickness is defined in the radial direction). [0298] In some examples, one or more of the cuts 404 extend through an entire thickness of the shaft 400. [0299] As introduced above, in some examples, the shaft 400 comprises metal, such as stainless steel. [0300] In some examples, each cut 404 has opposing end portions 406 that are wider than a width 408 of the elongated body 410 of the cut 404 (where the width is measured in the axial direction), as shown in FIG.15. The end portions 406 of the cuts 404 can be configured to provide strain relief to the shaft 400, thereby providing localized flexibility. [0301] In some examples, as shown in FIG.15, the end portions 406 are circular apertures. [0302] In some examples, the end portions 406 have another shape, such as square, oblong, star-shaped, or the like. [0303] The cuts 404 in adjacent rows 402 are staggered such that an individual cut 404 in a first row 402 is circumferentially offset from the closest neighboring cuts 404 in a second row 402 that is adjacent to the first row 402. The staggering of cuts 404 in adjacent rows 402 can mimic an interrupted spiral, thereby increasing the torsional strength of the shaft 400. [0304] In some examples, as shown in FIG.15, the cuts 404 in adjacent rows 402 overlap in the axial direction at their end portions 406. In some examples, the overlap of the cuts 404 can be consistent amongst the rows 402, such that axial lines drawn along the length of the shaft 400, through the overlapping portions of the cuts 404, extends through an end portion 406 of a cut 404 in each and every row 402. As a result, the torsional strength of the shaft 400 is further increased. [0305] In some examples, as shown in FIG.15, each cut 404 is centered relative to the closest two cuts 404 in the adjacent rows (e.g., the amount of overlap between the ends of the cuts is the same at both ends of the cut 404). [0306] The width 408 of the cuts 404, a number of cuts 404, a spacing between rows 402, and/or a spacing between adjacent cuts 404 in the same row 402 can vary based on a desired flexibility of the shaft 400. For example, a bendability of the shaft 400 may increase as the width 408 increases, the number of cuts 404 increases, the spacing between rows 402 decreases, and/or the spacing between adjacent cuts 404 decreases. However, these adjustments can result in more torque delay between the balloon shaft and the inflation balloon. As such, these variables may be selected to optimize both bendability and torque transfer of the shaft 400. [0307] FIGS.19-25 depict examples of different configurations and/or cut patterns for the cuts in the shaft 400. FIG.69 depicts another example of diamond-shaped cuts for any of the metal tubes or shafts described herein, as described further below. In some examples, the cuts 404 in the shaft 400 can be replaced by any of the cuts shown in FIGS.19-25 or 69. [0308] FIG.19 shows an example of cuts 450 that comprise an elongate body without wider end portions (for example, the cuts 450 do not have the wider end portions 406). [0309] FIG.20 shows an example of cuts 452 that also do not have wider end portions, but the cuts 452 are arranged at a non-zero angle relative to the circumferential direction. As such, the cuts 450 are spiral interrupted cuts. This arrangement of cuts 452 may help to prevent shearing of the shaft during rotation. [0310] In some examples, the amount of overlap between the cuts may be different than shown in FIG.15. For example, FIG.21 shows cuts 454, which are similar in shape to the cuts 404 (FIG.15), but the cuts 454 in adjacent rows overlap one another in the axial direction by a greater amount. Additionally, a ratio of a width of the end portions 456 to a width of the body 458 of the cuts 454 is larger than that of the cuts 404. [0311] As noted above the end portions 406 of the cuts 404 can have different shapes. FIG. 22 shows an example of cuts 460 having teardrop shaped end portions 462. FIG.23 shows an example of cuts 464 having oblong, rectangular, or “hammerhead” shaped end portions 466. [0312] FIG.24 shows an example of cuts 468 having additional triangular cuts 470 disposed along their body 472. The triangular cuts 470 extend outward from the body 472 at a location along the body 472 that is spaced apart from the wider end portions 474. This configuration may further increase the flexibility of that shaft. [0313] FIG.25 shows an example of cuts 476 having a body 478 that is wider than its end portions 480. For example, as shown in FIG.25, the body 478 narrows to the circular end portions 480 of the cuts 476. [0314] Returning to the discussion of FIGS.14-17, as introduced above, the shaft 400 can be included within a delivery apparatus, such as the exemplary delivery apparatus 420 shown in FIGS.14 and 17. As shown in FIG.14, the shaft 400 is coupled between the balloon shaft 426 and the inflation balloon 428 (which may also be referred to herein as an “inflatable balloon”). The delivery apparatus 420 can be the same or similar to the delivery apparatus 200, as described above, except for the inclusion of the shaft 400 underneath or over the crimp balloon 430. For example, the delivery apparatus 420 comprises the balloon shaft 426 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 420 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis 425 of the delivery apparatus 420. The delivery apparatus 420 further comprises an inner shaft 434 extending through the balloon shaft 426 to a polymeric body mounted on the distal end of the inner shaft 434. In some examples, the polymeric body can be the distal shoulder 336 and/or nose cone 332, as shown in FIG.6. [0315] In some examples, as shown in FIGS.14 and 17, the crimp balloon 430 extends over (and surrounds) the shaft 400 and extends from the balloon shaft 426 to the inflation balloon 428. Further, the shaft 400 extends over a portion of the inner shaft 434 (the portion extending past the distal end of the balloon shaft 426 and to the proximal end of the inflation balloon 428). [0316] In some examples, a first end (or proximal end) of the shaft 400 comprises a first attachment interface 412 and an opposite, second end (or distal end) of the shaft 400 comprises a second attachment interface 414. The first attachment interface 412 is configured to couple to the distal end of the balloon shaft 426, as shown in FIG.17. The second attachment interface 414 is configured to couple to a proximal end, or proximal leg, of the inflation balloon 428, as shown in FIG.17. [0317] In some examples, the first attachment interface 412 comprises a plurality of proximal struts 416 that are spaced apart around the first end and of the shaft 300 (as shown in FIGS. 16 and 17). The proximal struts 416 can be the same as the proximal struts 316 of shaft 300, as described above. For example, each proximal strut 416 can flare outward from the body 405 of the shaft 400 and spiral along and clamp to the distal end of the balloon shaft 426 (as shown in FIG.17). [0318] Additional examples of a first attachment interface for the shaft 400 (which can take the place of the proximal struts 416, in some examples) are shown in FIGS.26, 27A, 30, 32, 33, 34, 71-77B, and 78B (as described further below). The struts 416 or other features of first attachment interface 412 can be fixed to the shaft 426 by any of the various techniques or mechanisms described above with respect to the shaft 300. [0319] In some examples, the second attachment interface 414 comprises a plurality of axially extending struts 418 that are spaced circumferentially apart around the second end, as shown in FIG.15. The axially extending struts can be the same or similar to the axially extending struts 318, as described above, and can be fixed to the balloon 428 using any of the various techniques or mechanisms described above with respect to the shaft 300. [0320] In FIG.16, the shaft 400 has a different second attachment interface 414 comprising a plurality of distal struts 423 that are spaced apart around the second end and of the shaft 400. Each distal strut 423 can flare outward from the body of the shaft 400 and spiral along the proximal leg of the inflation balloon 428, as shown in FIG.17. [0321] In some examples, one or more, or each of, the distal struts 423 can comprise one or more apertures 422 in their flared, free ends, as shown in FIG.16. This can enable better bonding of the shaft 400 to the inflation balloon when a polymer is reflowed over this connection interface, as described below (for example, the polymer can flow through the apertures 422 and bond to the material of the proximal end of the inflation balloon 428). [0322] In some examples, each distal strut 423 clamps to an outer surface of the proximal leg of the inflation balloon 428 and/or extends through holes in the proximal leg of the inflation balloon 428. A polymer can be reflowed over the distal struts 423 and the proximal legs (or proximal end portion) of the inflation balloon 428, thereby bonding the shaft 400 to the inflation balloon 428. [0323] In some examples, a polymer is also reflowed over the crimp balloon 430, thereby securely bonding the proximal end of the inflation balloon 428, the distal end of the crimp balloon 430, and the attachment interface 412 of the shaft 400 together. In this way, a fluid seal can be created such that inflation fluid passing through a space between an outer surface of the inner shaft 434 and the inner surface of the crimp balloon 430 is fluidly connected to an interior of the inflation balloon 428. [0324] The shaft 400 is incompressible in the axial direction, thereby resulting in decreased delay in torque transfer. As a result, torque from the balloon shaft 426 can be more quickly transferred to the distal end of the shaft 400. [0325] However, in some examples, due to its incompressibility in the axial direction, it may not be desirable to size the shaft 400 such that it extends within the inflation balloon 428. [0326] In some examples, a shaft 500 can combine features of the shafts 300 and 400 to allow for axial compression within the balloon, but decreased torque delay for better torque transfer along a prosthetic valve mounting region of the shaft 500. For example, FIG.18 shows the exemplary shaft 500 that comprises a first section 502 comprising the cuts 404 and a second section 504 comprising the cuts 304. [0327] When included in a delivery apparatus, such as the delivery apparatus 200, 320, or 420, the first section 502 can extend from the balloon shaft to the proximal end of the inflation balloon and the second section 504 can extend from the proximal end of the inflation balloon to a distal end of the delivery apparatus (such as to the distal shoulder). The shaft 500 can comprise any of the attachment interfaces described herein at its proximal and/or distal ends. [0328] FIGS.26-34 show additional examples of attachment interfaces for the opposing ends of any of the crimp balloon shafts described herein, such as shafts 300, 400, 500, or 1700. Any of the attachment interfaces described herein can be replaced (or interchanged) with any of the attachment interfaces described below. [0329] Turning first to FIG.26, and an exemplary shaft 600 comprising opposing end portions defining attachment interfaces 612, 614 of the shaft 600 are shown. The shaft 600 comprise a body 602 extending between the first attachment interface 612 (or proximal attachment interface) and the second attachment interface 614 (or distal attachment interface). As shown in FIG.26, the body 602 comprises the same cuts 404 as the shaft 400 (as described above with reference to FIGS.14-17). However, it is possible for the body 602 to have any arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25). Further, one or more of the attachment interfaces (or end portions) of any of the shafts described here can be replaced by the first and/or second attachment interfaces 612, 614. [0330] The first attachment interface 612 and the second attachment interface 614 are tubular (annular) and they each comprise a plurality of cut-outs or openings 604. The openings 604 are configured to allow fluid transfer and reflow of a polymer from an outside of the first and second attachment interfaces 612, 614 to components arranged inside (or underneath) the first and second attachment interfaces 612, 614. [0331] For example, the first attachment interface 612 can be arranged over and coupled to the distal end of the balloon shaft (for example, balloon shaft 326 or 426). The second attachment interface 614 can be arranged over and coupled to the proximal end of the inflation balloon (for example, inflation balloon 328 or 428). As a polymer is reflowed over the first attachment interface 612 or second attachment interface 614, the polymer can flow into and through the openings 604 and bond to the shaft or balloon underneath (for example, the balloon shaft or the inflation balloon, respectively). In this way, the openings 604 allow for the formation of a stronger bond between the first and second attachment interfaces 612, 614 and the balloon shaft and inflation balloon, respectively. [0332] In some examples, the first and second attachment interfaces 624 and 626 of FIGS. 27A-27B, as described below, can be arranged over the first and second attachment interfaces 612 and 614, respectively, in shaft 600 and a polymer can reflow through the openings 604 into the first and second attachment interfaces 624 and 626 (which, in some examples, can be polymeric transition parts). [0333] In some examples, the openings 604 are spaced apart around and along each of the first attachment interface 612 and the second attachment interface 614. [0334] As shown in FIG.26, the openings 604 can be diamond-shaped and form a repeating pattern along and around the first attachment interface 612 and the second attachment interface 614. [0335] In some examples, the openings 604 can have a different shape, such as circular, square, oblong, triangular, or the like. [0336] In some examples, each of the first attachment interface 612 and the second attachment interface 614 can have a first section 606 without any openings 604 disposed between the respective attachment interface and the body 602. [0337] In some examples, each of the first attachment interface 612 and the second attachment interface 614 can have a second section 608 without any openings 604, disposed at its proximal end (for attachment interface 612) or its distal end (for attachment interface 614). [0338] In some examples, the shaft 600, including the first and second attachment interfaces 612, 614 comprise metal (such as stainless steel). [0339] In some examples, one or more of the opposing end portions of a crimp balloon shaft define attachment interfaces that are conical or tapered in shape and comprise a polymer (for example, Nylon). For example, FIGS.27A and 27B show an exemplary shaft 620 comprising a body 622 extending between a first attachment interface 624 (or proximal end portion) and a second attachment interface 626 (or distal end portion). [0340] In some examples, the body 622 comprises metal (such as stainless steel). [0341] As shown in FIGS.27A-27B, the body 622 comprises the same cuts 404 as the shaft 400 (as described above with reference to FIGS.14-17). However, it is possible for the body 622 to have any arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25). Further, one or more of the attachment interfaces (or end portions) of any of the shafts described here can be replaced by the first and/or second attachment interfaces 624, 626. [0342] The first attachment interface 624 and the second attachment interface 626 each taper radially inward (toward a central longitudinal axis of the shaft 620) from their respective free ends 628 to their attached end 629 that fit over and attach to the body 622, as shown in FIG. 27A. [0343] Thus, when the first attachment interface 624 is attached to the balloon shaft 426 (or any of the other balloon shafts described herein), as shown in FIG.27B, the first attachment interface 624 tapers from the larger outer diameter of the balloon shaft 426 to the smaller outer diameter of the body 622 of the shaft 620. [0344] Similarly, when the second attachment interface 626 is attached to the proximal end portion of the inflation balloon 428 (or any of the other inflation balloons described herein), as shown in FIG.27B, the second attachment interface 626 tapers from the larger outer diameter of the proximal end portion of the inflation balloon 428 to the smaller outer diameter of the body 622 of the shaft 620. [0345] Due to the first and second attachment interfaces 624, 626 comprising a softer polymer (rather than a rigid metal), they can provide strain relief at the connections between the shaft 600 and the balloon shaft and inflation balloon. [0346] In some examples, the first attachment interface 624 and/or the second attachment interface 626 can comprise slots, holes, or the like in their tapered portions, thereby providing a path for fluid to flow therethrough. [0347] In some examples, the first attachment interface 624 and the second attachment interface 626 can be arranged over the first and second attachment interfaces 612, 614, respectively, in shaft 600. In such examples, the attachment interfaces 624, 626 can be referred to as first and second outer attachment interfaces, and the attachment interfaces 612, 614 can be referred to as first and second inner attachment interfaces with the outer attachment interfaces extending coaxially over respective inner attachment interfaces. [0348] FIG.28 shows an exemplary attachment interface 630 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 630 can be a distal attachment interface that is configured to couple to an outer surface of and/or holes in a proximal end of the inflation balloon of the delivery apparatus (similar to as shown in FIGS. 11A-11B and 17). [0349] The attachment interface 630 comprises a plurality of struts 632 that are spaced circumferentially apart around the interface. Each strut 632 has a curved end portion 634 in the form of a hook at its distal end. [0350] In some examples, the curved end portion 634 of each strut 632 is configured to fit into and/or hook around a respective hole in the proximal end portion of the inflation balloon. [0351] In some examples, the curved end portion 634 of each strut 632 is configured to fit around and clamp to an outer surface of the proximal end portion of the inflation balloon. [0352] In some examples, the struts 632 can be bonded to the proximal end portion of the inflation balloon by a polymer reflowed over the struts 632 and the inflation balloon, as described herein (for example, as described above with reference to axially extending struts 318). [0353] FIG.29 shows an exemplary attachment interface 640 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 640 can be a distal attachment interface that is configured to couple to an outer surface of and/or holes in a proximal end of the inflation balloon of the delivery apparatus (similar to as shown in FIGS. 11A-11B and 17). [0354] The attachment interface 640 comprises a plurality of struts 642 that are spaced circumferentially apart around the interface. Each strut 642 has a curved or hooked end portion 644 at its distal end. The struts 642 can be similar to struts 632, except they have a hooked shape that flares outward and has a greater length. [0355] The attachment interfaces 630, 640 also can be used as proximal attachment interfaces for coupling to the distal end portion of a balloon shaft of the delivery apparatus. [0356] FIG.30 shows an exemplary attachment interface 650 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 650 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface. [0357] The attachment interface 650 comprises a plurality of struts 652 that are spaced circumferentially apart around the interface. Similar to the struts 316 and 416 described above, each strut 652 can flare outward from the body of the shaft and spiral along the distal end of the balloon shaft (for example as shown in FIGS.10, 12, and 16). In some examples, each strut 652 clamps to an outer surface of the distal end of the balloon shaft. [0358] In some examples, each strut 652 extends from a lattice structure of the attachment interface 650. The lattice structure can comprise a plurality of spaced apart and repeating openings 654. These openings can provide a fluid path for a polymer reflowed over the attachment interface 650 (and the distal end of the balloon shaft). [0359] In some examples, the lattice structure defined by the struts 652 can be configured to flare, or radially expand and compress, like a stent. [0360] It should be noticed that the lattice structure can vary and have openings with different sizes, shapes, and/or arrangement than that shown in FIG.30. [0361] FIG.31 shows an exemplary attachment interface 660 for any of the crimp balloon shafts described herein. [0362] In some examples, the attachment interface 660 can be a distal attachment interface that is configured to couple to an outer surface of and/or holes in a proximal end of the inflation balloon of the delivery apparatus (similar to as shown in FIGS.11A-11B and 17). [0363] In some examples, the attachment interface 660 can be a proximal attachment interface that is configured to couple to an outer surface of a balloon shaft of the delivery apparatus. [0364] The attachment interface 660 comprises a plurality of struts 662 that are spaced circumferentially apart around the interface. Each strut 662 extends axially from a base or body of the shaft of which it is part. Each strut 662 comprises an elongated (or a longer length than width) slot 664 (or opening). The slot 664 can extend from a base of the strut 662 toward, but spaced apart from a tip 666 of the strut 662. The slots 664 can provide a larger opening and surface area for a polymer to reflow therethrough and bond to an underlying component (such as the proximal end of the inflation balloon). [0365] FIG.32 shows an exemplary attachment interface 670 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 670 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface. [0366] The attachment interface 670 comprises a plurality of struts 672 (for example, two, three, or the like) that are spaced circumferentially apart around the interface. Each strut 672 can comprise a leg 674 and a distal end 676 having a relatively large opening 678 (for example, the opening 678 can be at least three times larger or wider than a width of the material or strut at the distal end that forms the opening 678). In some examples, the width of the distal end 676 is wider than a width of the leg 674 where it connects to the distal end 676. [0367] The struts 672 can be configured to clamp around an outer surface of the distal end of the balloon shaft. The relatively wide openings 678 are configured to receive a reflowed polymer therethrough, thereby providing enhanced bonding between the balloon shaft and the attachment interface 670. [0368] In some examples, the attachment interface 670 comprises two struts 672, which provide better alignment with the balloon shaft during assembly. [0369] FIG.33 shows an exemplary attachment interface 680 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 680 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface. [0370] The attachment interface 680 comprises a plurality of struts 682 that are spaced circumferentially apart around the interface. Similar to the struts 672, each strut 682 can comprise a leg 684 and a distal end 686 having a relatively large opening 688 (for example, the opening 688 can be at least three times larger or wider than a width of the material or strut at the distal end that forms the opening 688). In some examples, the width of the distal end 686 is wider than a width of the leg 684 where it connects to the distal end 686. [0371] The struts 682 can be configured to clamp around an outer surface of the distal end of the balloon shaft. The relatively wide openings 688 are configured to receive a reflowed polymer therethrough, thereby providing enhanced bonding between the balloon shaft and the attachment interface 680. [0372] In comparison to the attachment interface 670, the legs 684 can have a different shape (for example, wider along most of their length) and the openings 688 in the distal ends 686 can be slightly narrower. In some examples, the wider legs 684 can hold the flare better (flare outward from the body of the shaft) and be stronger and more resistant to deformation under torque (when attached to the balloon shaft). [0373] FIG.34 shows an exemplary attachment interface 690 for any of the crimp balloon shafts described herein. In some examples, the attachment interface 690 can be a proximal attachment interface that is configured to couple to a distal end of the balloon shaft of the delivery apparatus (similar to as shown in FIGS.10, 12, and 17), although it also can be used as a distal attachment interface. [0374] The attachment interface 690 is tubular and comprises a proximal end portion 692 that is configured to be coupled to the balloon shaft of the delivery apparatus, a distal end portion 694 that is configured to be coupled (such as via welding) to the crimp balloon shaft (the body), and an intermediate portion 696 that tapers from the proximal end portion 692 to the distal end portion 694. [0375] The proximal end portion 692 has a larger diameter than the distal end portion 694, and thus the intermediate portion 696 tapers and transitions radially inward from the proximal end portion 692 to the distal end portion 694. The diameter of the proximal end portion 692 can be sized to fit around the distal end of the balloon shaft and the diameter of the distal end portion 694 can be sized to fit against and be bonded to an outer surface of the body of the crimp balloon shaft (such as body 305 or 405). [0376] In some examples, the distal end portion 694 is welded (for example, laser welded) to the body of the crimp balloon shaft. [0377] The proximal end portion 692 can include a plurality of spaced apart openings 698 that provide a fluid path for a polymer that is reflowed over the proximal end portion 692 mounted around a balloon shaft, thereby bonding the overlapping parts together. Although the openings 698 are depicted in FIG.34 as rectangular, the openings 698 can have various shapes and/or sizes, such as oblong, square, trapezoidal, or the like. [0378] In some examples, as shown in FIG.34, the intermediate portion 696 can include a plurality of spaced apart openings 699 for receiving the reflowed polymer therethrough. [0379] In some examples, the attachment interface 690 is a separate component that is machined, thereby holding the concentricity of the attachment interface 690 better than flared strut attachments. In some examples, the attachment interface 690 comprises a metal that is the same or similar to the metal of the crimp balloon shaft to which it is bonded (such as stainless steel). [0380] FIG.70 depicts an exemplary relatively rigid tube or shaft 1700, that may be similar to the shaft 400 and/or the shaft 600 described above. For example, the shaft 1700 can comprise metal, such as stainless steel (for example, the shaft 1700 may be a hypotube), with opposing end portions defining first and second attachment interfaces 1712, 1714 and a main body 1702 extending between the first and second attachment interfaces 1712, 1714. [0381] The shaft 1700 can be included in a delivery apparatus, such as any of the delivery apparatuses described herein, and extend from a balloon shaft of the delivery apparatus (for example, balloon shaft 426 shown in FIG.14 or the balloon shaft 226 shown in FIG.5B) to an inflation balloon of the delivery apparatus (for example, inflation balloon 428 shown in FIG.14 or the inflation balloon 228 shown in FIG.5B). In some examples, the shaft 1700 can be used in lieu of the shaft 400 in the delivery apparatus 420. [0382] As shown in FIG.70, the body 1702 comprises a plurality of cuts 1704 (for example, diamond shaped cuts as shown) (which may be the same or similar to the cuts 1610 shown in FIG.69). In some examples, the cuts 1704 can be arranged into a plurality of circumferentially extending rows of cuts 1704, where the rows are spaced axially apart along the body 1702 of the shaft 1700, relative to a central longitudinal axis 1706 of the shaft 1700. Each row comprises a plurality of individual cuts 1704 that are spaced circumferentially apart around the shaft 1700. A major (or long) axis of each diamond shaped cut 1704 extends in the circumferential direction. [0383] In some examples, the cuts 1704 extend through an entire thickness of the shaft 1700 (that is, a wall of the shaft 1700), thereby forming openings in the shaft. [0384] The cuts 1704 in adjacent rows are staggered such that an individual cut 1704 in a first row is circumferentially offset from the closest neighboring cuts 1704 in a second row that is adjacent to the first row. The staggering of cuts 1704 in adjacent rows can mimic an interrupted spiral, thereby increasing the torsional strength of the shaft 1700. [0385] As described above with reference to the cuts 404, the width of the cuts 1704 (as defined in the axial direction), the length of the cuts 1704 (as defined in the circumferential direction), a number of cuts 1704, a spacing between rows, and/or a spacing between adjacent cuts 1704 in the same row can vary based on a desired flexibility of the shaft 1700. For example, a bendability of the shaft 1700 may increase as the width of the cuts 1704 increases, the number of cuts 1704 increases, the spacing between rows decreases, and/or the spacing between adjacent cuts 1704 decreases. However, these adjustments can result in more torque delay between the balloon shaft and the inflation balloon. As such, these variables may be selected to optimize both bendability and torque transfer of the shaft 1700. [0386] As described herein, it is possible for the body 1702 to have any of the arrangement of cuts, or combinations thereof, disclosed herein (such as cuts 304, 404 or any of the cuts shown in FIGS.19-25 or 69). Further, one or more of the attachment interfaces (or end portions) of any of the shafts described here can be replaced by the first and/or second attachment interfaces 1712, 1714. [0387] As described herein, a diameter of the body 1702 can be minimized to reduce a crimp profile of a prosthetic device mounted thereon, while still allowing an inner shaft of the delivery apparatus to pass therethrough with clearance therebetween. [0388] The first attachment interface 1712 is configured to be coupled to a distal end of the balloon shaft (for example, the balloon shaft 426, similar to as shown in FIG.17). The second attachment interface 1714 is configured to be coupled to a proximal end portion (or proximal leg) of the inflation balloon (for example, the inflation balloon 428, similar to as shown in FIG.17). [0389] The first attachment interface 1712 and the second attachment interface 1714 comprise lattice structures that are configured to radially expand to different sizes (and radially compress to a less radially expanded or at least partially radially collapsed configuration when being coupled to a balloon leg or balloon shaft). The lattice structures can comprise one or more circumferentially extending rows of cells (which can also be referred to as openings) arranged end-to-end around the first attachment interface 1712 and the second attachment interface 1714. The cells or openings allow for fluid transfer, such as a polymer passing therethrough during reflowing or bonding a balloon or other polymeric layer thereto. The lattice structure of cells allows the first attachment interface 1712 and the second attachment interface 1714 to radially expand from a radially collapsed configuration (e.g., as shown in FIG.72A) to a radially expanded configuration (e.g., as shown in FIG. 72B). [0390] As shown in FIG.70, the first attachment interface 1712 and the second attachment interface 1714 each have an expanded configuration that flares radially outward from the body 1702 to a respective free end 1716, 1718 of the attachment interfaces. Similar to the other attachment interfaces described herein, the flared ends of the first attachment interface 1712 and the second attachment interface 1714 allow them to be coupled to the wider balloon shaft (for example, balloon shaft 426) and proximal leg of the inflation balloon (for example, inflation balloon 428) more easily. Further, by being expandable to different sizes (or diameters), the first attachment interface 1712 and the second attachment interface 1714 can couple to various sizes of balloon shafts and inflation balloons (for example, in different delivery apparatuses). The first attachment interface 1712 and the second attachment interface 1714 can then be at least partially compressed around the balloon shaft or proximal leg of the inflation balloon to couple and bond securely thereto. [0391] For example, FIGS.71-72B depict the second attachment interface 1714 in a flattened (non-cylindrical) configuration (FIG.71), a radially collapsed configuration (FIG.72A), and a radially expanded configuration (FIG.72B). The lattice structure of the second attachment interface 1714 can comprise at least a first circumferentially extending row of first cells 1720 disposed at the free end 1718 of the second attachment interface 1714. The first cells 1720 have an elongated convex hexagon shape (as compared to a length of the cells in adjacent rows, where the length is defined in the axial direction) and form apices 1721 defining the free end 1718. [0392] The lattice structure of the second attachment interface 1714 optionally can comprises a second circumferentially extending row of second cells 1722 disposed adjacent to the first cells 1720, a third circumferentially extending row of third cells 1724 disposed adjacent to the second cells 1722, a fourth circumferentially extending row of fourth cells 1726 disposed adjacent to the third cells 1724, and/or a fifth circumferentially extending row of fifth cells 1728 disposed adjacent to the fourth cells 1726. This lattice structure, which can be referred to herein as a diamond lattice structure, can have enhanced strength for torque transfer. [0393] As best seen in FIG.71, in some examples, a length (in the axial direction) of the cells in each row decreases from the first row of first cells 1720 to the fifth row of fifth cells 1728 (e.g., the length 1719 of the first cells 1720 is larger than the length 1723 of the second cells 1722, which is larger than the length 1725 of the third cells 1724, and so on). [0394] The second cells 1722, third cells 1724, fourth cells 1726, and fifth cells 1728 can have a diamond shape, as shown in FIGS.71-72B [0395] As the second attachment interface 1714 is radially expanded at its free end 1718, or flared radially outward, the cells of the lattice structure widen (in the circumferential direction), with a width 1717 of the first cells 1720 increasing the most, as compared the cells in adjacent rows, as shown in FIG.72B. As a result, the second attachment interface 1714 can more easily fit around the inflation balloon and be bonded thereto. [0396] For example, FIGS.73A-73D depict an exemplary process for manufacturing the shaft 1700, and similar tubes for a delivery apparatus, and flaring and bonding the second attachment interface 1714 to an inflation balloon 428. As shown in FIGS.73A and 73B, the process begins by cutting (e.g., laser cutting) or otherwise forming the cuts 1704 (or any of the other cuts described herein) and the cells of the first and second attachment interfaces 1712, 1714 (which may be any of the attachment interfaces described herein) into a tube 1710 (e.g., a metal tube or hypotube). This results in the shaft 1700 shown in FIG.73B (which may be the same as the shaft 1700 shown in FIG.70, except the second attachment interface 1714 has a more simplified lattice structure with fewer circumferentially extending rows of cells, for ease of illustration). As shown in FIG.73B, the second attachment interface 1714 can be in its radially collapsed or non-flared configuration after the cutting/forming step. [0397] The second attachment interface 1714 can then be flared radially outward using a flaring tool which results in the flared configuration shown in FIG.73C. In this configuration, the second attachment interface 1714 increases in diameter from the body 1702 to its free end 1718. As a result, the first cells 1720 widen and the second attachment interface 1714 can fit around a proximal leg of the inflation balloon 428. The second attachment interface 1714 can be radially compressed around and bonded to the inflation balloon 428, as shown in FIG.73C. In some examples, a radial compression bonding apparatus can apply radially inward pressure and heat to the second attachment interface 1714 arranged around the proximal leg of the inflation balloon 428 in order to bond the second attachment interface 1714 to the inflation balloon 428. [0398] A crimp balloon 430 can be positioned over the shaft 1700 and a portion of the second attachment interface 1714, as shown in FIG.73D. The crimp balloon 430 can be reflowed over the second attachment interface 1714, such that polymer can flow through the cells of the second attachment interface 1714 and to the underlying inflation balloon 428, thereby bonding the crimp balloon 430 to the inflation balloon 428 with the second attachment interface 1714 coupled therebetween. In some examples, the crimp balloon 430 can extend over and cover the entire outer surface of the attachment interface 1714. [0399] FIGS.74A-76B depict examples of different attachment interfaces comprising a lattice structure, which can be used in lieu of the second attachment interface 1714 in the shaft 1700 or similar shafts. In some examples, the attachment interfaces shown in FIGS. 74A-76B can additionally or alternatively be used in lieu of the first attachment interface 1712. [0400] FIGS.74A and 74B depict a flattened (non-cylindrical) view (FIG.74A) and a flared or radially expanded view (FIG.74B) of an attachment interface 1760 with a lattice structure comprising a plurality of circumferentially extending rows of cells that are arrayed from a free end 1762 of the attachment interface 1760 to the body of the shaft (e.g., the body 1702 of the shaft 1700). Specifically, as shown in FIG.74A, the attachment interface 1760 comprises a first row of first cells 1764, a second row of second cells 1765, a third row of third cells 1766, a fourth row of fourth cells 1767, a fifth row of fifth cells 1768, and a sixth row of sixth cells 1769, all cells of which are diamond shaped. The first cells 1764 and second cells 1765 are the largest and the cells in the other rows decrease in size from the second row to the sixth row. This configuration results in an attachment interface 1760 with an increased number of cells (compared to other attachment interfaces described herein), which allows for more even polymer mating to the inflation balloon and crimp balloon. [0401] FIGS.75A and 75B depict a flattened (non-cylindrical) view (FIG.75A) and a flared or radially expanded view (FIG.75B) of an attachment interface 1770 with a lattice structure comprising a plurality of circumferentially extending rows of cells that are arrayed from a free end of the attachment interface 1770 to the body of the shaft (e.g., the body 1702 of the shaft 1700). Specifically, as shown in FIG.75A, the attachment interface 1770 comprises a first row of first cells 1774, a second row of second cells 1775, a third row of third cells 1776, a fourth row of fourth cells 1777, and a fifth row of fifth cells 1778, all cells of which have an elongated diamond shape. The attachment interface 1770 also comprises a sixth row of sixth cells 1779 that have an irregular diamond shape with pairs of adjacent sixth cells 1779 angling toward each other. The attachment interface 1770 also comprises a seventh row of seventh cells 1772 that have a curved wedge shape. This configuration of cells provides a longer tapered ramp (when the attachment interface 1770 is in the flared configuration, as shown in FIG.75B) from the body of the shaft to the proximal leg of the inflation balloon, which improves valve alignment and movement when a prosthetic valve is moved from a position around the crimp balloon to a position around the inflation balloon. [0402] FIGS.76A and 76B depict a flattened (non-cylindrical) view (FIG.76A) and a flared or radially expanded view (FIG.76B) of an attachment interface 1780 with a lattice structure comprising a first circumferentially extending row of first cells 1784, a second circumferentially extending row of second cells 1786 disposed adjacent to the first cells 1784, and a third circumferentially extending row of third cells 1788 disposed adjacent to the second cells 1786. Apices 1782 of the first cells 1784 define a free end of the attachment interface 1780. The first cells 1784 have an elongated convex hexagon shape with thicker axially extending sides 1785 that are shared between adjacent first cells 1784. The first cells 1784 also comprise curved cutouts 1783 at edge junctions of the first cells 1784. The cutouts 1783 allow the first cells 1784 to be radially compressed down after flaring, such as when the attachment interface 1780 is radially compressed and bonded to the proximal leg of the inflation balloon. The second cells 1786 and third cells 1788 have a diamond shape. [0403] Returning to FIG.70, the lattice structure of the first attachment interface 1712 is shown in more detail in FIGS.77A and 77B. FIG.77A and 77B depict a flattened (non- cylindrical) view (FIG.77A) and a flared or radially expanded view (FIG.77B) of the first attachment interface 1712 with a lattice structure comprising at least a first circumferentially extending row of first cells 1730, which in some examples have an elongated convex hexagonal shape as shown. In some examples, each first cell 1730 can be split into an outer cell 1732 (having a diamond shape) at the free end 1716 of the first attachment interface 1712, a first inner cell 1734 (having a chevron shape), and a second inner cell 1736 (having a chevron shape), wherein the first inner cell 1734 is formed by a first V-shaped strut 1738 and a second V-shaped strut 1740 that span a width of the first cell 1730. The first V-shaped strut 1738 and second V-shaped strut 1740 are spaced axially apart within the first cell 1730 by axial struts 1733. The first inner cells 1734 and second inner cells 1736 are configured to allow for easier insertion into a pocket or cavity in the balloon shaft (such as the cavity 1904 of the balloon shaft 1926, as shown in FIG.84, which is described in greater detail below) while also maintaining anchoring to the balloon shaft. [0404] In some examples, as shown in FIG.77A, the struts defining the first cells 1730, including the first V-shaped strut 1738 and the second V-shaped strut 1740, have cut-outs or notches 1748 disposed at the ends of the first V-shaped strut 1738 and the second V-shaped strut 1740. These cut-outs 1748 allow for easier and/or greater flaring at the free end of the first attachment interface 1712, as shown in FIG.77B. [0405] In some examples, the lattice structure optionally can further comprise one or more additional rows of cells, such as a second circumferentially extending row of diamond shaped second cells 1742, a third circumferentially extending row of diamond shaped third cells 1744, and/or a fourth circumferentially extending row of diamond shaped fourth cells 1746. The fourth cells 1746 are smaller than the third cells 1744, and the third cells 1744 are smaller than the second cells 1742. [0406] As the first attachment interface 1712 is radially expanded at its free end 1716, or flared radially outward, the cells of the lattice structure widen (in the circumferential direction), with a width of the first cells 1730 increasing the most, as compared the cells in adjacent rows, as shown in FIG.77B. As a result, the first attachment interface 1712 can more easily fit around the balloon shaft and be bonded thereto. [0407] For example, FIGS.78A-78D depict an exemplary process for manufacturing the shaft 1700, and similar shafts for a delivery apparatus, and flaring and bonding the first attachment interface 1712 to the balloon shaft (balloon shaft 426 is shown by way of example, but any balloon shaft of a delivery apparatus, such as any of the balloon shafts described herein may be used). The first attachment interface 1712 can be replaced by any of the attachment interfaces described herein. [0408] As shown in FIGS.78A and 78B, the process begins by cutting (e.g., laser cutting) or otherwise forming the cuts 1704 (or any of the other cuts described herein) and the cells of the first and second attachment interfaces 1712, 1714 (which may be any of the attachment interfaces described herein) into a tube 1710 (e.g., a metal tube or hypotube). This results in the shaft 1700 shown in FIG.78B (which may be the same as the shaft 1700 shown in FIG. 70). In FIG.78B, the first attachment interface 1712 is in its radially collapsed or non-flared configuration or state. [0409] The first attachment interface 1712 can then be flared radially outward using a flaring tool which results in the flared configuration shown in FIG.78C. In this configuration, the first attachment interface 1712 increases in diameter from the body 1702 to its free end 1716. As a result, the first cells 1730 widen (as best seen in FIG.77B) and the first attachment interface 1712 can fit around and/or within a distal end portion of the balloon shaft (e.g., balloon shaft 426 or balloon shaft 1926 shown in FIG.84). The first attachment interface 1712 is then bonded to the balloon shaft, as shown in FIG.78C. [0410] For example, the flared first attachment interface 1712 can be inserted into a pocket or cavity formed within the distal end portion of the balloon shaft. As shown in FIG.84, in some examples, a distal end portion 1902 of a balloon shaft 1926 for a delivery apparatus can comprise a cavity 1904 defined between a first braided layer 1906 and a second braided layer 1908 of the balloon shaft 1926. More specifically, the distal end portion 1902 of the balloon shaft 1926 can comprise a stepped or flared end 1910 that flares radially outward from a main shaft portion 1912 of the balloon shaft 1926, relative to a central longitudinal axis 1914 of the balloon shaft 1926. It should be noted that the amount of flare (or size of the step) of the flared end 1910 may be exaggerated in FIG.84 for the purpose of illustration only. Moreover, it should be noted that for purposes of illustration, the distal end portion of the second braided layer 1908 is shown as forming a sharp step relative to a proximal portion of the second braided layer 1908. The second braided layer 1908 can form a smooth or gradual flared transition section extending from the proximal portion to the distal portion at location of the pocket. [0411] Within the flared end 1910, a space or cavity 1904 is formed between the first braided layer 1906, which can comprise a metal braid, and the second braided layer 1908, which can comprise a metal braid. In some examples, a polymer layer (e.g., formed from PEBAX) can extend co-axially between the first braided layer 1906 and the second braided layer 1908. In some examples, an inner polymer layer (e.g., formed from PEBX) can extend co-axially through and cover an inner surface of the first braided layer 1906. The balloon shaft 1926 can further comprise an outer polymeric layer 1916 (or jacket) surrounding the second braided layer 1908. The polymer layers can be reflowed such that the first and second braided layers 1906, 1908 become embedded within the polymer layers. [0412] In some examples, one or more of the first braided layer 1906 and the second braided layer 1908 may not include a metal braid, or the metal braid may not extend into or all the way through the distal end portion 1902. [0413] Thus, the flared first attachment interface 1712 can be inserted into the cavity 1904, as shown in FIG.84, and then radially compressed around the first braided layer 1906. The first attachment interface 1712 is then bonded (e.g., split die bonded) to the balloon shaft 1926, within the cavity 1904. For example, after inserting the first attachment interface 1712 into the cavity 1904, as shown in FIGS.78C and 84, the distal end portion 1902 of the balloon shaft 1926 can be inserted into a bonding apparatus that applies radially inward pressure (i.e., compression) and heat to the assembled distal end portion 1902 and first attachment interface 1712. As this interface is heated, polymer from the first braided layer 1906 and/or the second braided layer 1908 can flow through the cells (e.g., cells 1732, 1734, and 1736) in the first attachment interface 1712, thereby bonding the first attachment interface 1712 and the distal end portion 1902 to each other, as shown in FIG.78D. [0414] The balloon shaft 1926 can be used in lieu of any of the balloon shafts in any of the delivery apparatuses described herein, such as the balloon shaft 226 or the balloon shaft 426. [0415] A crimp balloon 430 can be positioned over the shaft 1700 and the distal end portion 1902 of the balloon shaft 1926 (for example, over the outer polymeric layer 1916), as shown in FIG.78D. The crimp balloon 430 is reflowed over the outer polymeric layer 1916 of the balloon shaft 1926, thereby bonding the crimp balloon 430 to the balloon shaft 1926. [0416] In some examples, instead of being inserted into a cavity of a balloon shaft, the flared first attachment interface 1712 can be fit over and radially compressed around a distal end portion of a balloon shaft (such as balloon shaft 426 or any of the other balloon shafts described herein) and then bonded to the balloon shaft (for example, by reflowing a polymer around the first attachment interface 1712 and the outer polymeric layer or jacket of the balloon shaft). The crimp balloon 430 can then be bonded thereto, as described above. [0417] FIGS.79-83B depict examples of different attachment interfaces comprising a lattice structure, which can be used in lieu of the first attachment interface 1712 in the shaft 1700 or similar shafts. In some examples, the attachment interfaces shown in FIGS.79-73B can additionally or alternatively be used in lieu of the second attachment interface 1714. [0418] FIG.79 depicts a flattened (non-cylindrical) view of an attachment interface 1800 with a lattice structure comprising a first circumferentially extending row of first cells 1804, a second circumferentially extending row of second cells 1806 disposed adjacent to the first cells 1804, and a third circumferentially extending row of third cells 1808 disposed adjacent to the second cells 1806. Apices 1802 of the first cells 1804 define a free end of the attachment interface 1800. The first cells 1804 have an elongated convex hexagon shape, while the second cells 1806 and third cells 1808 have a tapered diamond shape. This lattice structure can be referred to as a “tapered lattice” and can provide more even stress distribution across the attachment interface 1800. [0419] FIG.80 depicts a flattened (non-cylindrical) view of an attachment interface 1810 with a lattice structure comprising a first circumferentially extending row of first cells 1814, a second circumferentially extending row of second cells 1816 disposed adjacent to the first cells 1814, and a third circumferentially extending row of third cells 1818 disposed adjacent to the second cells 1816. Apices 1812 of the first cells 1814 define a free end of the attachment interface 1810. The first cells 1814 have an elongated convex hexagon shape with thicker axially extending sides 1815 having an hourglass or bowtie shape. The second cells 1816 and third cells 1818 have a diamond shape. The axially extending sides 1815 of the first cells 1814 can be configured to prevent over expansion of the attachment interface. [0420] FIGS.81A and 81B depict a flattened (non-cylindrical) view (FIG.81A) and a flared or radially expanded view (FIG.81B) of an attachment interface 1820 with a lattice structure comprising a first circumferentially extending row of first cells 1824, a second circumferentially extending row of second cells 1826 disposed adjacent to the first cells 1824, and a third circumferentially extending row of third cells 1828 disposed adjacent to the second cells 1826, and a fourth circumferentially extending row of fourth cells 1830 disposed adjacent to the third cells 1828. Apices 1822 of the first cells 1824 define a free end of the attachment interface 1820. The first cells 1824, second cells 1826, and third cells 1828 have a hexagonal-like shape with curved or rounded axially opposing ends. The fourth cells 1830 have a diamond-like shape with a wider base at the end disposed opposite the third cells 1828. The shape of the fourth cells 1830 allows for maximum fluid flow therethrough and the shape of the first cells 1824 allows for easier flaring when expanded to the flared configuration shown in FIG.81B. [0421] FIGS.82A and 82B depict a flattened (non-cylindrical) view (FIG.82A) and a flared or radially expanded view (FIG.82B) of an attachment interface 1840 with a lattice structure comprising a first circumferentially extending row of first cells 1844, a second circumferentially extending row of second cells 1846 disposed adjacent to the first cells 1844, a third circumferentially extending row of third cells 1848 disposed adjacent to the second cells 1846, and a fourth circumferentially extending row of fourth cells 1849 disposed adjacent to the third cells 1848. Apices 1842 of the first cells 1844 define a free end of the attachment interface 1840. The first cells 1844 each have an elongated convex hexagon shape with an axially extending strut 1845 bisecting the first cell 1844. This configuration allows the first cells 1844 to deform radially outward and help anchor into the pocket shaft. [0422] FIGS.83A and 83B depict a flattened (non-cylindrical) view (FIG.83A) and a flared or radially expanded view (FIG.83B) of an attachment interface 1850 with a lattice structure comprising a first row of first cells 1852, a second row of second cells 1853, a third row of third cells 1854, a fourth row of fourth cells 1855, and a fifth row of fifth cells 1856. The first cells 1852, second cells 1853, and third cells 1854 all have an elongated diamond shape. In some examples, as shown in FIGS.83A and 83B, the first cells 1852, second cells 1853, and third cells 1854 are all the same size, or at least substantially the same size. The fourth cells 1855 have an irregular diamond shape with pairs of adjacent fourth cells 1855 angling toward each other. The fifth cells 1856 have a curved wedge-like shape. The fourth cells 1855 and fifth cells 1856 define a transition zone 1857 of the attachment interface 1850 that transitions from the body of the shaft and the flared free end 1858 of the attachment interface 1850, as shown in FIG.83B. This provides increased strength to the attachment interface 1850 in the flared state. [0423] Turning now to FIGS.35-37, a flexible tube or shaft 700 (which can also be referred to herein as a crimp balloon shaft) comprising a plurality of interconnected struts 702 that define a plurality of openings 704 (which can also be referred to herein as cells or open cells) in the shaft 700 is shown. The struts 702 form a lattice structure (for example, a diamond lattice structure), as described further below. The shaft 700 is configured to extend from a balloon shaft to an inflation balloon of a delivery apparatus. The shaft 700 is shown coupled to and extending distally from an exemplary balloon shaft 326 in FIG.37. [0424] In some examples, the shaft 700 can extend from the distal end of the balloon shaft at least to the proximal end of the inflation balloon in a delivery apparatus, such as the delivery apparatus 200, 320, or 420. For example, the shaft 700 can be used in lieu of the shaft 300 in the delivery apparatus 320 shown in FIG.6. [0425] In some examples, the shaft 700 can extend from the distal end of the balloon shaft to the distal shoulder of the delivery apparatus, such as the delivery apparatus 200, 320, or 420. For example, the shaft 700 can be used in lieu of the shaft 300 in the delivery apparatus 320 shown in FIG.13. [0426] The shaft 700 is radially compressible and bendable. For example, the shaft 700 comprises alternating sections that are configured to compress radially (provided by first sections 706 of the shaft 700) and flex or bend about a central longitudinal axis of the shaft 700 (provided by second sections 708 of the shaft 700). [0427] As shown in FIG.35, the shaft 700 can comprise one or more first sections 706 (three are shown in FIGS.35 and 37) and one or more second sections 708 (two are shown in FIGS. 35 and 37) which alternate with each other along the length of the shaft. Thus, each second section 708 is arranged between two adjacent first sections 706. [0428] In some examples, the shaft 700 can comprise more or less first sections 706 and/or second sections 708 than those shown in FIGS.35 and 37. For example, the shaft 700 can comprises two first sections 706 and one second section 708 or four first sections 706 and three second sections 708. [0429] FIG.36 shows an enlarged view of a portion of the shaft 700 in a flattened configuration. Each first section 706 comprises struts 702 that form a first diamond lattice structure with diamond-shaped first cells 712 having a long dimension oriented in the axial direction. Each second section 708 comprises struts 702 that form a second diamond lattice structure with diamond-shaped second cells 714 having a long dimension oriented in the circumferential direction. [0430] The struts 702 of the first and second sections 706, 708 are directly connected to one another, such that the first and second sections 706, 708 are interconnected along the shaft 700. [0431] For example, as shown in FIG.36, the shaft 700 can comprise axially extending struts 716 and Y-shaped struts 718 (which can collectively be referred to herein as connecting struts) that extend between strut junctions at an end of a first section 706 and strut junctions at an end of a second section 708. [0432] FIG.37 illustrates the bendability of the shaft 700 at each of the second sections 708. A proximal-most first section 706 can be coupled to the distal end of the balloon shaft of the delivery apparatus, as shown in FIG.37. [0433] In some examples, a distal-most first section 706 can be coupled to a proximal end portion of the inflation balloon of the delivery apparatus (for example, as shown in FIG.40 for shaft 740). [0434] In some examples, a distal-most first section 706 can be coupled to the distal shoulder of the delivery apparatus (for example, as shown in FIG.45 for shaft 780). [0435] A prosthetic valve can be crimped (radially compressed) around one of the first sections 706 for delivery through a patient’s vasculature toward an implantation site. [0436] The shaft 700 can also be configured to compress in the axial direction. [0437] In some examples, the struts 702 of the shaft comprises a shape memory metal, such as Nitinol. [0438] In some examples, the shaft 700 is arranged over the crimp balloon (as shown in FIG. 37), and thus it is disposed outside of the inflation fluid path of the delivery apparatus. In such cases, an outer surface of the shaft 700 can be coated with a polymeric coating. [0439] In some examples, the shaft 700 is arranged underneath (within) the crimp balloon. In such cases, a polymeric coating may not be needed. [0440] In some examples, shafts similar to shaft 700 can have a different lattice structure (or structures) and/or arrangement of struts. Examples of such shafts, that are bendable and compressible and formed by struts are described below with reference to FIGS 38-44. Although some of FIGS.38-44 depict shafts in a flattened configuration (non-cylindrical), it should be noted that these shafts can assume a cylindrical and closed configuration, such as shown in FIGS.35 and 37. In some examples, the shafts shown in FIGS.38-44 can comprise a shape memory metal, such as Nitinol. [0441] FIG.38 shows a strut structure for an exemplary crimp balloon shaft 720, similar to shaft 700, in a flattened configuration. The shaft 720 comprises struts 722 that form a diamond lattice structure with diamond-shaped cells 724 having a long dimension oriented in the axial direction. [0442] Due to the diamond lattice structure, the shaft 720 can be radially compressible. [0443] FIGS.39 and 40 show an exemplary shaft 740 in a flattened configuration (FIG.39) and a cylindrical configuration, in a delivery apparatus 750 (FIG.40). The shaft 740 comprises alternating sections of first struts 742 and second struts 744. The first struts 742 can be configured to provide bendability to the shaft 740, while the second struts 744 can allow the shaft 740 to compress circumferentially. [0444] Each section of first struts 742 comprises a plurality of first struts 742 arranged end- to-end in a zig-zag pattern that extends in a circumferential direction (around the shaft 740). [0445] Each section of second struts 744 comprises a plurality of rows of second struts 744, each row comprising second struts 744 arranged end-to-end in a zig zag pattern that extends in an axial direction. Each row of second struts 744 connects to first struts 742 in two adjacent sections of first struts 742. [0446] As shown in FIG.40, the shaft 740 can be coupled between the balloon shaft 756 and the inflation balloon 758. The delivery apparatus 750 can be the same or similar to the delivery apparatuses 200, 320 or 420, as described above, except for the inclusion of the shaft 740 over the crimp balloon (or underneath in some examples). For example, the delivery apparatus 750 comprises the balloon shaft 756 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 750 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis of the delivery apparatus 750. The delivery apparatus 750 further comprises an inner shaft 757 extending through the balloon shaft 756 to a polymeric body (for example, distal shoulder 759) mounted on the distal end of inner shaft 757. [0447] FIGS.41-42 show an exemplary shaft 760 in a flattened configuration (full view shown in FIG.41 and a detail view of a portion of the shaft 760 shown in FIG.42). The shaft 760 comprises a plurality of interconnected struts 762 forming a diamond lattice structure. For example, the struts 762 define openings or cells 764 having a diamond shape. [0448] The lattice structure of the shaft 760 can be similar to that of shaft 720, except the struts 762 can include alternating cuts 766 that extend into the strut 762 from opposing edges 768 of the strut 762, as shown in the detail view of FIG.42. Each cut 766 can extend into the strut 762 from a first one of the opposing edges 768 but not all the way to a second one of the opposing edges 768. In this manner, each strut 762 with cuts 766 has a serpentine pattern along the strut where the cuts are present. By spacing the cuts 766 in an alternating fashion along each strut 762, the struts 762 are provided with flexibility so that the shaft 760 can bend (about the central longitudinal axis of the shaft 760). [0449] FIGS.43-44 show an exemplary shaft 780 in a flattened configuration (FIG.43) and a cylindrical configuration, in a delivery apparatus 790 (FIG.44). The shaft 780 comprises a first section 782 of first struts 783 forming a diamond lattice structure (like the structure of shaft 720, as described above). The shaft 780 also comprises second and third sections 784, 785 of alternating second struts 786 and third struts 787 (which correspond to and may be the same as the first struts 742 and second struts 744, respectively, of the shaft 740, as described above). [0450] The shaft 780 also comprises a fourth section 788 of straight struts 789 that are spaced circumferentially apart around the shaft 780. Each straight strut 789 can extend between second struts 786 of the second section 784 and second struts 786 of the third section 785. [0451] The struts of the sections of the shaft 780 can be interconnected such that all of the sections of the shaft 780 are continuous with one another. [0452] As shown in FIG.44, the shaft 780 can be coupled between the balloon shaft 792 and the distal shoulder 794 (and/or the nose cone 796) of the delivery apparatus 790. The delivery apparatus 790 can be the same or similar to the delivery apparatuses 200, 320 or 420, as described above, except for the inclusion of the shaft 780 over the crimp balloon (or underneath in some examples). For example, the delivery apparatus 790 comprises the balloon shaft 792 (which may the same as the balloon shaft 226) extending from a handle of the delivery apparatus 790 (such as the handle portion 220), which is configured to rotate around a central longitudinal axis of the delivery apparatus 790. The delivery apparatus 790 further comprises an inner shaft extending through the balloon shaft 792 to a polymeric body (for example, distal shoulder 794 and nose cone 796) mounted on the distal end of inner shaft. [0453] In some examples, as shown in FIG.44, the shaft can be configured such that the fourth section 788 is arranged over (or underneath in some examples) the inflation balloon of the delivery apparatus 790 and forms a region 798 that is configured to receive the radially compressed prosthetic valve thereon prior to inflating the inflation balloon for deploying the prosthetic valve at an implantation site. [0454] The second and third section 784, 784 can form compressible shoulders on both sides of the region 798. [0455] For delivery through a patient’s vasculature, toward an implantation site, the prosthetic valve can be mounted in a radially compressed configuration around a portion of the first section 782. Once inside the patient’s vasculature, the prosthetic valve can be slid from the first section 782 to the fourth section 788, such as by moving an outer shaft 222 (shown in FIG.5A) distally relative to the balloon shaft 792 and/or moving the balloon shaft 792 proximally relative to the outer shaft 222, as previously described. Once the prosthetic valve is positioned on the fourth section 788, the delivery apparatus can be advanced to position the prosthetic valve within a native valve annulus (e.g., a native aortic valve) and the balloon can be inflated to expand the prosthetic valve. [0456] In this way, the shaft 780 can provide structural support for the prosthetic valve, while also being bendable and compressible, thereby enabling the delivery apparatus 790 to navigate through bends in the patient’s vasculature and deploy the prosthetic valve by inflating the inflation balloon. [0457] FIGS.46A-46E show relatively rigid tubes or shafts (which can be referred to herein as “crimp balloon shafts”) that can be used to support a sleeve/crimp balloon of a delivery apparatus (e.g., crimp balloon 225 shown in FIG.45). In some examples, the shafts or tubes shown in FIGS.46A-46E can replace the tube 229 in FIG.45, thereby extending underneath and through the crimp balloon 225. [0458] In some examples, the shafts or tubes shown in FIGS.46A-46E, particularly if they are axially compressible, can extend from the balloon shaft, through the inflatable balloon, and to a distal end of the delivery apparatus. [0459] In some examples, the shafts or tubes shown in FIGS.46A-46E, can extend from the balloon shaft to a proximal end portion of the inflatable balloon. [0460] Turning first to FIG.46A, a shaft 800 comprising a plurality of apertures 802 (which can also be referred to as holes, openings, or pores) along its length is depicted. In some examples, the shaft 800 can be configured to be arranged underneath a crimp balloon and extend between (and, in some instances, couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 800 can be used in lieu of tube 229 in FIG.45). [0461] The apertures 802 can be configured to provide fluid communication between an inner lumen of the shaft 800, which is fluidly connected to inner lumens of the balloon shaft (e.g., balloon shaft 226 shown in FIG.45) and the inflatable balloon (e.g., balloon 28 shown in FIG.45). As such, inflation fluid can pass through the apertures 802 into the crimp balloon (e.g., crimp balloon 225 shown in FIG.45) to allow partial inflation of the crimp balloon, for example. [0462] The shaft 800 can comprise a polymer of a specified thickness and/or stiffness that makes it rigid enough to support the crimp balloon and a prosthetic valve mounted thereon, and effectively transfer torque from the balloon shaft to the distal end of the crimp balloon (without significant torque delay), while also enabling the shaft 800 to bend as the delivery apparatus navigates a patient’s anatomy in route to an implantation site. Example polymers can include one or more of Polyurethane, polyvinyl chloride, high-density polyethylene, Pebax, Silicone, and/or the like. [0463] The apertures 802 can be sized to allow fluid therethrough. In some examples, all the apertures 802 can have the same diameter. In some examples, the apertures 802 can have varying diameters (e.g., at least one aperture 802 can have a different diameter than another aperture 802). [0464] The apertures 802 can be spaced apart along a majority of a length of the shaft 800. [0465] In some examples, the apertures 802 can be spaced apart along an entire length of the shaft 800. [0466] In some examples, as shown in FIG.46A, the apertures 802 can be spaced apart and extend around the shaft 800 in a spiral or helical pattern. [0467] In some examples, the shape, size, and pattern of the apertures 802 along the length of the shaft 800 can be specified such that it provides effective torque transfer between the opposing ends of the shaft 800, while maintaining flexibility of the shaft 800 (so it can bend). [0468] In some examples, when the shaft 800 comprises a polymer with increased flexibility, it may not include apertures 802. [0469] FIG.46B shows a shaft 810 comprising a plurality of spaced apart apertures 812 (which can also be referred to as holes or openings). In some examples, the shaft 810 can be configured to be arranged underneath a crimp balloon and extend between (and, in some instances, couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 810 can be used in lieu of tube 229 in FIG.45). [0470] In some examples, the shaft 810 comprises metal (e.g., stainless steel). [0471] The apertures 812 can be configured (e.g., sized, shaped, and arranged along the shaft 810) to provide flexibility to the shaft 810 (particularly when the shaft 810 is metal), while maintaining enough rigidity to effectively transfer torque from a first end of the shaft 810 (e.g., the end coupled to the balloon shaft) to an opposite, second end of the shaft 810 (e.g., the end coupled to the inflatable balloon). [0472] For example, a diameter of each aperture 812, spacing between adjacent apertures 812, a pattern of apertures 812 along the shaft 810, and the like, can be specified to produce a shaft 810 that can bend, while also effectively transferring torque along the shaft 810. [0473] In some examples, the apertures 812 can be arranged along a majority of a length of the shaft 800. [0474] In some examples, the apertures 812 can be spaced apart from the first end 814 and second end 816 of the shaft 810, thereby providing surfaces to attach to the balloon shaft and inflatable balloon. [0475] In some examples, the apertures 812 can be arranged in a plurality of longitudinally extending columns 818, the columns 818 spaced apart around a circumference of the shaft 810. [0476] In some examples, the apertures 812 can provide fluid communication between the inner (or central) lumen of the shaft 810, which is fluidly connected to inner lumens of the balloon shaft (e.g., balloon shaft 226 shown in FIG.45) and the inflatable balloon (e.g., balloon 28 shown in FIG.45). As such, inflation fluid can pass through the apertures 812 into the crimp balloon (e.g., crimp balloon 225 shown in FIG.45) to allow partial inflation of the crimp balloon, for example. [0477] In some examples, when the shaft 810 comprises a material with increased flexibility such that it can easily bend, it may not include apertures 812. [0478] FIG.46C shows a shaft 820 comprising a plurality of circumferentially extending rows 822 of cuts that are spaced axially apart from one another along a body of the shaft 820. In some examples, the shaft 820 can be configured to be arranged underneath a crimp balloon and extend between (and, in some instances, couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 820 can be used in lieu of tube 229 in FIG.45). [0479] In some examples, the shaft 820 comprises metal (e.g., stainless steel). [0480] The shaft 820 can have a puzzle cut pattern, and thus, is similar to the shaft 300 except for the shape of its cuts 824. [0481] In some examples, each row 822 of cuts is a continuous (or mostly continuous) cut 824 that extends around a circumference of the shaft 820 and forms a plurality of rings 825, each of which is formed with a projection 826 and an opposing indentation 828 (also referred to as notches). For example, a projection 826 of one ring 825 is shaped to fit within an indentation 828 of an adjacent ring 825, thereby fitting together like a puzzle. [0482] As a result, the shaft 820 can bend, while still being rigid enough to effectively transfer torque along its length. [0483] The shape, size, and/or number of cuts 824 and their projections 826 and indentations 828 can vary based on a desired flexibility (bendability) of the shaft, similar to as described above with reference to the shaft 300. [0484] Further, the cuts 824 allow the shaft 820 to compress axially (in an axial direction defined along a central longitudinal axis of the shaft and delivery apparatus). Thus, in some examples, the shaft 820 can extend underneath the inflatable balloon to a distal end portion of the delivery apparatus. [0485] FIG.46D shows a shaft 830 comprising a braided mesh body 832 (or woven mesh body) extending between first and second end portions 834, 836 of the shaft 830. In some examples, the shaft 830 can be configured to be arranged underneath a crimp balloon and extend between (and couple to each of) a balloon shaft and inflatable balloon (e.g., the shaft 830 can be used in lieu of tube 229 in FIG.45). [0486] In some examples, the shaft 830 comprises metal (e.g., stainless steel). [0487] The braided mesh body 832 comprises a plurality of strands 838 (e.g., round or flat metal strands) that are woven together to define the mesh structure and openings 839 between overlapping strands 838. [0488] This structure allows the shaft 830 to bend. [0489] In some examples, this woven or braided mesh structure allows the shaft 830 to compress axially. [0490] In some examples, the shaft 830 can compress radially (in the radial direction which is perpendicular to the axial direction and a central longitudinal axis of the shaft 830). As a result, when a prosthetic valve is crimped thereon, the shaft 830 can compress radially to reduce an overall crimp profile of the prosthetic valve on the delivery apparatus. [0491] In some examples, one or both of the first end portion 834 and the second end portion 836 can have a relatively solid or non-braided surface that is configured to couple (e.g., via bonding by reflowing a polymer over the end portion) to either the inflatable balloon or the balloon shaft. In some examples, the first end portion 834 and/or the second end portion 836 can be replaced by any of the attachment interfaces described herein. [0492] FIG.46E shows a shaft in the form of a coil spring 840 (which can also be referred to herein as a “coil”). In some examples, the coil spring 840 can be configured to be arranged underneath (within) a crimp balloon and extend from a balloon shaft to an inflatable balloon (e.g., the coil spring 840 can be used in lieu of tube 229 in FIG.45). [0493] In some examples, the coil spring 840 comprises metal (e.g., stainless steel). [0494] In some examples, the coil spring 840 comprises a polymer. [0495] A pitch 842 and/or thickness of the material of the coil spring 840 can be specified such that the coil spring 840 can bend, while also being able to support a prosthetic valve mounted thereon and transmit torque along its length. [0496] The coil spring 840 can be radially compressible, such that it can be crimped radially inward with the prosthetic valve. [0497] Due to its coiled structure, the coil spring 840 can allow inflation fluid to pass therethrough and allow a crimp balloon surrounding the coil spring 840 to inflate. [0498] When the crimp balloon collapses onto the coil spring 840 (such as when a prosthetic valve is radially compressed thereon, or after the prosthetic valve is radially compressed thereon and moved over to the inflatable balloon), torque can be effectively transferred along the coil spring 840, to a proximal end portion of an inflatable balloon. [0499] FIGS.47A-47D depict an example of assembling the coil spring 840 with an inflatable balloon (e.g., inflatable balloon 228 comprising proximal balloon leg 850), crimp balloon 225, and balloon shaft 226. The coil spring 840 comprises a first end portion 844 and a second end portion 846, the second end portion 846 disposed opposite the first end portion 844. In some examples, as shown in FIG.47A, the first and second end portions 844, 846 can have a larger pitch than a main body 848 of the coil spring 840. [0500] In some examples, the first and second end portions 844, 846 can have the same pitch as the main body 848. [0501] As shown in FIG.47A, the first end portion 844 is inserted into a proximal balloon leg 850 of the inflatable balloon 228. [0502] The crimp balloon 225 can be slid over the coil spring 840 such that its distal end overlaps the first end portion 844, and in some examples the proximal balloon leg 850, as shown in FIG.47B. [0503] As shown in FIG.47C, the second end portion 846 of the coil spring 840 is inserted into the distal end portion of the balloon shaft 226. In some examples, a proximal end portion of the crimp balloon 225 can be arranged over the distal end portion of the balloon shaft 226 (as shown in FIG.47C). [0504] The distal end portion of the crimp balloon 225 is bonded to the proximal balloon leg 850 and the proximal end portion of the crimp balloon 225 is bonded to the distal end portion of the balloon shaft 226 (e.g., by reflowing a polymer over the overlapping shafts and balloons). This bonding can also bond and/or hold the coil spring 840 in place, as shown in FIG.47D. [0505] FIG.47D depicts the bendability of the coil spring 840. [0506] FIG.46F shows a portion of a coiled wire shaft 860 comprising multiple layers of coiled wire. In some examples, the coiled wire shaft 860 can be configured to be arranged underneath (within) a crimp balloon and extend from a balloon shaft to an inflatable balloon (e.g., the coiled wire shaft 860 can be used in lieu of tube 229 in FIG.45). [0507] In some examples, the coiled wire shaft 860 comprises metal (e.g., stainless steel). [0508] In some examples, the coiled wire shaft 860 comprises a first layer 862 of coiled wire coiling in a first direction and a second layer 864 of coiled wire coiling in a second direction that is different from the first direction (e.g., opposite the first direction). [0509] In some examples, the coiled wire shaft 860 can comprise more than two layers of coiled wire, such as three, four, five layers or the like. In some examples, the multiple layers of coils can alternate coiling in opposite directions. [0510] In some examples, multiple layers of coiled wire that coil or revolve in different directions can reduce the likelihood of the coils opening or collapsing when torqued in one or both directions. In this way, by incorporating multiple layers of overlapping coiled wire in which different layers coil in opposing directions, the shaft 860 can be more robust and more effectively transfer torque along its length. [0511] In some examples, the coiled wire of the coiled wire shaft 860 can be a flat wire (as shown in FIG.46F), a round wire (as shown in FIG.46G), or combinations thereof. [0512] FIG.47G shows a portion of a coiled wire shaft 870 comprising a single layer of coiled wire. In some examples, the coiled wire shaft 870 can be configured to be arranged underneath (within) a crimp balloon and extend from a balloon shaft to an inflatable balloon (e.g., the coiled wire shaft 870 can be used in lieu of tube 229 in FIG.45). [0513] In some examples, the coiled wire shaft 870 comprises metal (e.g., stainless steel). [0514] In some examples, the coiled wire of the coiled wire shaft 870 can be a flat wire (as shown in FIG.46F), a round wire (as shown in FIG.46G), or combinations thereof. [0515] FIGS.48-50 depict an exemplary inflatable balloon 900 that comprises an inflatable body 902, a distal leg 904 (or end portion), and a proximal leg 906 (or end portion). The distal leg 904 can be configured to be coupled to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG.6). The proximal leg 906 can be longer than a proximal leg of a more traditional inflatable balloon (e.g., longer than the proximal leg of the balloon 228 in FIGS.2 and 5) and extends underneath the crimp balloon 225 (as shown in FIGS.48 and 50). [0516] In some examples, the balloon 900 can replace the inflatable balloon 228 in the delivery apparatus 200. [0517] The proximal leg 906 has a length 908 that is longer than a crimped height 910 of the prosthetic valve 912 to be mounted thereon (as shown in FIG.50). It should be noted that the length 908 of the proximal leg 906 may be longer than actual in FIG.50, for the purpose of illustration, and in some instance the length 908 may be closer to the crimped height 910 of the prosthetic valve than shown in FIG.50. [0518] In some examples, the proximal leg 906 can extend and couple to a distal end of the balloon shaft (e.g., balloon shaft 226 of delivery apparatus 200 in FIG.2 or balloon shaft 326 of FIG.6). [0519] In some examples, the proximal leg 906 and the crimp balloon 225 are approximately the same length and both couple to the distal end of the balloon shaft. [0520] In some examples, the proximal leg 906 is longer than the crimp balloon 225 and the proximal end 914 of the crimp balloon 225 is bonded to and around (e.g., by reflowing a polymer) the proximal leg 906, proximal to the balloon shaft (as shown in the example of FIG.50). [0521] A distal end 916 of the crimp balloon 225 can be bonded to the proximal leg 906, adjacent to the inflatable body 902 of the balloon 900, as shown in the example of FIG.50. [0522] The balloon 900 comprises a polymer. [0523] In some examples, the proximal leg 906 has stiffness that is greater than a stiffness of the inflatable body 902 of the balloon 900. The stiffness can be relatively high and specified such that the proximal leg 906 can provide support for the prosthetic valve 912 crimpled thereon and provide effective torque transfer along its length (during an implantation procedure). However, the proximal leg 906 can still be configured to bend as it is navigated through bends in a patient’s anatomy. [0524] An outer diameter 918 of the proximal leg 906 can be relatively small to minimize a crimp profile of the prosthetic valve 912 mounted thereon. This outer diameter 918 can be customized for each size of valve. In some examples, the outer diameter 918 of the proximal leg 906 can be less than 5 mm. [0525] The proximal leg 906 comprises a plurality of holes 920 spaced apart along its length 908. The holes 920 can extend through an entire thickness of the proximal leg (from a lumen defined by the proximal leg 906 to an outer surface of the proximal leg 906), and thus can be configured to allow inflation fluid therethrough and inflation and deflation of the crimp balloon 225. Thus, the width or diameter of the holes 920 can be specified such that inflation fluid can pass therethrough and allow inflation/deflation of the crimp balloon 225. [0526] In some examples, the holes 920 can all have the same diameter. [0527] In some examples, at least one hole 920 can have a different diameter than another hole 920. [0528] A number of the holes 920 can also be specified to allow for optimal inflation and deflation of the crimp balloon 225. [0529] In some examples, the proximal leg 906 may not include any holes 920, and instead may be configured to bend and transfer torque. [0530] In some examples, the holes 920 can be spaced apart along an entire length 908 of the proximal leg 906. A spacing between adjacent holes 920 can be specified based on a desired amount of inflation fluid to pass therethrough to the crimp balloon 225. [0531] In some examples, the holes 920 can be spaced apart and spiral around a circumference of the proximal leg 906, as they extend along the proximal leg 906, as shown in FIGS.48-50. [0532] In some examples, the holes 920 can be arranged in a different pattern along the proximal leg 906, such as in circumferentially extending rings of spaced apart holes 920, where the rings are spaced axially apart along the proximal leg 906. [0533] In some examples, the holes 920 can have different shapes, such as circular, oblong, square, rectangular, triangular, or the like. [0534] As explained herein, when the delivery apparatus has reached or is proximate to an implantation site, and after the prosthetic valve 912 has been repositioned onto the inflatable body 902 of the balloon, the prosthetic valve 912 can be rotated by rotating the balloon shaft, which results in rotation of the balloon and the prosthetic valve 912 mounted thereon to achieve a desired rotational alignment of the prosthetic valve with respect to the native annulus. The body 902 can then be inflated, thereby radially expanding, and deploying the prosthetic valve 912 at the implantation site. [0535] FIGS.51-52B depict an exemplary inflatable balloon 1000 that comprises an inflatable body 1002, a distal leg 1004 (or end portion), and a proximal leg 1006 (or end portion). The distal leg 1004 can be configured to be coupled to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG.6). The proximal leg 1006 can be longer than a proximal leg of a more traditional inflatable balloon (e.g., longer than the proximal leg of the balloon 228 in FIGS.2 and 5) and can replace (or serve as) the crimp balloon. [0536] In some examples, the balloon 1000 can replace the inflatable balloon 228 in the delivery apparatus 200 and the proximal leg 1006 can replace the crimp balloon. In this way, a delivery apparatus including the balloon 1000 does not need an additional crimp balloon. [0537] The proximal leg 1006 has a length 1008 that is longer than a crimped height of the prosthetic valve to be mounted thereon. [0538] In some examples, the proximal leg 1006 can extend and couple to a distal end of the balloon shaft (e.g., balloon shaft 226 of delivery apparatus 200 in FIG.2 or balloon shaft 326 of FIG.6). [0539] The balloon 1000 comprises a polymer. [0540] In order to achieve a flexibility for navigating through bends in a patient’s anatomy, the proximal leg 1006 can have a plurality of radially and circumferentially extending ribs defining a plurality of spaced apart radially and circumferentially extending recesses 1010 (or indentations or cut-outs) along its length 1008, thereby creating alternating sections of low and high diameters along the proximal leg 1006 (as shown in FIGS.52A and 52B). [0541] An example cross-section of a selected portion 1012 of the proximal leg 1006 is shown in FIG.52A. As seen in FIG.52A, each recess 1010 extends from an outer surface 1020 of the proximal leg 1006 toward, but spaced away from, a lumen 1018 (which may be a central lumen) of the proximal leg 1006. The lumen 1018 is configured to receive inflation fluid therethrough, which passes into an interior of the inflatable body 1002 of the balloon 1000. [0542] In some examples, one or more of the recesses 1010 are annular recesses that each extend around an entire circumference of the proximal leg 1006. [0543] In some examples, one or more of the recesses 1010 are semi-annular recesses that each extend around a portion of the entire circumference of the proximal leg 1006. [0544] A depth 1014 of the recesses 1010, a width 1016 of the recesses 1010, and/or a spacing 1015 (or distance) between adjacent recesses 1010 can be specified such that the proximal leg 1006 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure). [0545] In some examples, the recesses 1010 can be formed by laser etching the proximal leg of the balloon 1000. [0546] In some examples, as shown in FIG.52B, a thin polymeric film 1022 (or sleeve or layer of tubing) can be disposed over the outer surface 1020 of the proximal leg 1006, thereby allowing the prosthetic valve to move (slide) from the proximal leg 1006 to the body 1002 of the balloon 1000 with greater ease. [0547] In some examples, the thin polymeric film 1022 can be a polymeric coating, film, or tubing, that reduces friction between the prosthetic valve and the proximal leg 1006. [0548] FIGS.53-55C depict an exemplary balloon 1100 that comprises an inflatable body 1102, a distal leg 1104 (or end portion), and a proximal leg 1106 (or end portion). The distal leg 1104 can be configured to couple to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG. 6). The proximal leg 1106 can be coupled to a shaft 1108. [0549] In some examples, the balloon 1100 can be the same or similar to the balloon 228 in FIGS.2 and 5. [0550] The shaft 1108 can replace (or serve as) the crimp balloon. As such, the shaft 1108 is configured to receive a prosthetic valve radially compressed or crimped thereon. In some examples, the shaft 1108 can extend and couple to a distal end of the balloon shaft (e.g., balloon shaft 226 of delivery apparatus 200 in FIG.2 or balloon shaft 326 of FIG.6). [0551] The shaft 1108 has a length 1110 that is longer than a crimped height of the prosthetic valve to be mounted thereon. [0552] In some examples, the shaft 1108 can be semi-crimpable, or compressible in the radial direction. For example, the shaft 1108 can have a stiffness that is configured to allow for effective torque transfer along its length (e.g., for rotating the prosthetic valve mounted thereon at or near the implantation site), but also enable the shaft 1108 to compress (when crimping the prosthetic valve thereon) and inflate (when receiving inflation fluid therethrough) at least partially. [0553] For example, the shaft 1108 can have a stiffness in a range of 0.5 – 2.0 GPa. [0554] In some examples, the shaft 1108 can comprise Nylon or Pebax with a hardness in a range of 40-85D. [0555] An outer diameter 1112 of the shaft 1108 can be relatively small to minimize a crimp profile of the prosthetic valve mounted thereon. This outer diameter 1112 can be customized for each size of valve. In some examples, the outer diameter 1112 can be less than 5 mm. [0556] In some examples, an outer surface 1114 of the shaft 1108 can be relatively smooth such that a prosthetic valve crimped thereon can be easily slid off the shaft 1108 and onto the body 1102 of the balloon 1100. [0557] The outer surface 1114 of the shaft 1108 can be fluidly sealed (and solid) such that fluid cannot pass out of or into the shaft 1108 through the outer surface 1114. [0558] To achieve a flexibility for navigating through bends in a patient’s anatomy, in some examples, the shaft 1108 can have a corrugated cross-section (as shown in the example of FIG.54) or multiple lumens extending axially through the shaft 1108 (as shown in the examples of FIGS.55A-55C). [0559] FIG.54 is a longitudinal cross-section of a portion of the shaft 1108, according to an example. In the example of FIG.54, the shaft 1108 comprises a central lumen 1120 with channels or recesses 1122 extending from the central lumen 1120 into the shaft 1108, toward the outer surface 1114. The recesses 1122 do not extend all the way to the outer surface 1114 (they are spaced away from the outer surface 1114). [0560] In some examples, as shown in FIG.54, the recesses 1122 are radially extending. [0561] In some examples, the recesses 1122 extend at a non-parallel and non-perpendicular angle relative to a central longitudinal axis of the central lumen 1120 (and the shaft 1108). [0562] The recesses 1122 are spaced axially apart along the shaft 1108, thereby creating corrugations that increase the flexibility of the shaft 1108 and enable it to bend. [0563] A depth 1124 of the recesses 1122, a width 1126 of the recesses 1122, and/or a spacing 1128 (or distance) between adjacent recesses 1122 can be specified such that the shaft 1108 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure). [0564] In some examples, one or more of the recesses 1122 are annular recesses 1122. [0565] FIG.55A is a radial cross-section of the shaft 1108, according to an example. In the example of FIG.55A, the shaft 1108 comprises a central lumen 1130 with a plurality of lumens 1132 spaced apart from one another around the central lumen 1130. Both the central lumen 1130 and the lumens 1132 are longitudinally or axially extending lumens (extending in a direction of a central longitudinal axis of the central lumen 1130 and shaft 1108). [0566] Each lumen 1132 is radially offset from the central lumen 1130 and circumferentially offset from adjacent lumens 1132. [0567] A width or diameter of each lumen 1132 and the spacing between adjacent lumens 1132 can be specified such that the shaft 1108 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure). [0568] In some examples, as shown in FIG.55A, each lumen 1132 has circular cross-section. [0569] In some examples, the shaft 1108 can comprise lumens having different cross- sectional shapes and/or sizes. For example, FIG.55B is a radial cross-section of the shaft 1108, according to an example, where a plurality of channels or lumens 1142 having a non- circular shape surround a central lumen 1140. Both the central lumen 1140 and the lumens 1142 are longitudinally or axially extending lumens (extending in a direction of a central longitudinal axis of the central lumen 1140 and shaft 1108). [0570] Each lumen 1142 is radially offset from the central lumen 1140 and circumferentially offset from adjacent lumens 1142. [0571] A width or cross-sectional area of each lumen 1142 and the spacing between adjacent lumens 1142 can be specified such that the shaft 1108 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure). [0572] The lumens 1142 of FIG.55B have a larger cross-sectional area and smaller spacing between one another than the lumens 1132 of FIG.55A. [0573] In some examples, the lumens 1142 have a cross-sectional shape of a quadrilateral with two opposing angled sides and two opposing curved ends. [0574] FIG.55C is a radial cross-section of the shaft 1108, according to an example. In the example of FIG.55C, the shaft 1108 comprises a central lumen 1150 with a plurality of first lumens 1152 spaced apart from one another around the central lumen 1150 and a plurality of second lumens 1154 spaced apart from one another around the first lumens 1152. [0575] All of the central lumen 1150, first lumens, 1152, and second lumens 1154 are longitudinally or axially extending lumens (extending in a direction of a central longitudinal axis of the central lumen 1150 and shaft 1108). [0576] Each first lumen 1152 is radially offset from the central lumen 1150 and circumferentially offset from adjacent first lumens 1152. [0577] Each second lumen 1154 is radially offset from the central lumen 1150 and the first lumens 1152 and circumferentially offset from adjacent second lumens 1154. [0578] In some examples, as shown in FIG.55C, the first lumens 1152 have a different shape and/or size than the second lumens 1154. [0579] A width or cross-sectional area of each lumen 1152, 1154 and the spacing between adjacent lumens 1152, 1154 can be specified such that the shaft 1108 is able to bend (as it is navigated through the patient’s anatomy), while still being stiff enough to provide support for the prosthetic valve crimpled thereon and for transferring torque along its length (e.g., for rotating the prosthetic valve mounted thereon during an implantation procedure). [0580] In some examples, the lumens 1152 and/or 1154 can have different shapes than shown in FIG.55C. [0581] FIGS.56A and 56B depict an exemplary inflatable balloon 1200 that comprises an inflatable body 1202, a distal leg 1204 (or end portion), and a proximal leg 1206 (or end portion). The distal leg 1204 can be configured to be coupled to a distal end of a delivery apparatus, such as to a nosecone and/or distal shoulder (e.g., nose cone 232 of FIG.5 or distal shoulder 336 of FIG.6). The proximal leg 1206 can be longer than a proximal leg of a more traditional inflatable balloon (e.g., longer than the proximal leg of the balloon 228 in FIGS.2 and 5) and can replace or serve as the crimp balloon. [0582] In some examples, the balloon 1200 can replace the inflatable balloon 228 in the delivery apparatus 200 and the proximal leg 1206 can replace the crimp balloon 225 (as shown in FIG.5B). In this way, a delivery apparatus including the balloon 1200 does not need an additional crimp balloon. [0583] The proximal leg 1206 has a length 1208 that can be longer than a crimped height of the prosthetic valve to be mounted thereon. [0584] In some examples, the proximal leg 1206 can extend and couple to a distal end of the balloon shaft (e.g., balloon shaft 226 of delivery apparatus 200 in FIGS.2 or 45, or balloon shaft 326 of FIG.6). [0585] In some examples, the proximal leg 1206 can comprise nylon or another balloon material. [0586] In some instances, the proximal leg 1206 can be integrated and formed as one piece (e.g., one molding or casting) with the remainder of the balloon 1200 (the inflatable body 1202 and distal leg 1204). [0587] In some examples, as shown in FIGS.56A and 56B, the proximal leg 1206 comprises a plurality of longitudinal pleats 1210 (extending in a direction of a central longitudinal axis of the balloon and delivery apparatus). For example, the longitudinal pleats can comprise folds in a material of the proximal leg 1206, with a crease of the fold extending in the longitudinal direction. [0588] The longitudinal pleats 1210 provide the proximal leg 1206 with more structure and rigidity, such that it can flex as needed when navigating through bends in a patient’s anatomy, but it can also effectively transfer torque along its length to the inflatable body 1202 of the balloon 1200. For example, the longitudinal pleats 1210 can make the proximal leg 1206 more rigid in is deflated state (as shown in FIG.56B, for example, due to the overlapping material of the balloon at each pleat) than a proximal leg that doesn’t include longitudinal pleats. [0589] The proximal leg 1206 can at least partially inflate with inflation fluid, as shown in the at least partially inflated state of the balloon 1200 in FIG.56A. [0590] In some examples, the proximal leg 1206 comprises a Pebax and nylon composite (such as Tie layer), thereby providing the proximal leg 1206 with more rigidity and allowing it to effectively transfer torque from the balloon shaft to the inflatable boxy 1202. [0591] The proximal leg 1206 is configured (with a specified rigidity or stiffness) such that a prosthetic valve mounted on the proximal leg 1206 or a prosthetic valve mounted on the inflatable body 1202 can be rotated by the balloon 1200 with effective torque transfer along the proximal leg 1206 from the balloon shaft. [0592] In some examples, a portion of the balloon shaft of a delivery apparatus, such as the balloon shaft 226, can extend underneath the crimp balloon 225 toward or to the inflatable balloon 228. This portion of the balloon shaft 226 can be configured to effectively transmit torque from the distal end of the full balloon shaft 226 to the inflatable balloon 226. In some examples, this balloon shaft portion extending underneath the crimp balloon 225 can also be compressible, thereby enabling a prosthetic valve to be crimped thereon, as described herein. [0593] For example, FIGS.57A-57C show a first braided layer 1300 (which can also be referred to as a “first braid 1300” or a “first braided tube 1300”) of the balloon shaft 226 (or another, similar balloon shaft) extending outward from a distal end 1326 of the balloon shaft 226 (as shown in FIGS.57A and 57B) to the inflatable balloon 228 (e.g., to a proximal leg of the inflatable balloon 228,as shown in FIG.57C). [0594] The portion of the first braided layer 1300 extending inside the crimp balloon 225 can be referred to as the extension portion 1302 of the first braided layer 1300. In some examples, the extension portion 1302 can also be referred to as a braided tube 1302. [0595] In some examples, the extension portion 1302 of the first braided layer 1300 can be used in lieu of tube 229 in FIG.45. [0596] As shown in the schematic cross-sectional view of FIG.57A, the balloon shaft 226 can comprise a polymeric jacket 1304 (which can also be referred to as a “casing”) that defines a radially inward facing surface 1306 and radially outward facing surface 1308 of the balloon shaft 226. In some examples, the balloon shaft 226 can comprise one or more layers of a braided (or coil) material extending through or within the polymeric jacket 1304. [0597] In some examples, the braided or coil material(s) can comprise a more rigid braided or coiled material, such as metal or polyethylene terephthalate (PET), of one or more different sizes (e.g., diameters). [0598] In some examples, as shown in FIG.57A, the balloon shaft 226 can comprise the first braided layer 1300 and a second braided layer 1310. [0599] In some examples, the second braided layer 1310 can extend to the distal end 1326 of the balloon shaft 226. [0600] In some examples, the second braided layer 1310 can be spaced away from the distal end 1326, and therefore not extend all the way to the distal end 1326. [0601] In some examples, the first braided layer 1300 can extend along a majority of a length of the balloon shaft 226, from a handle of the delivery apparatus. [0602] In some examples, the second braided layer 1310 can extend along a majority of a length of the balloon shaft 226, from a handle of the delivery apparatus. [0603] In some examples, the first braided layer 1300 is 4x12 AWG. [0604] In some examples, the first braided layer 1300 comprises a material having a pores per inch of 45 ppi. [0605] The distal end of the extension portion 1302 of the first braided layer 1300 can bond to the proximal leg of the inflatable balloon 228 using a polymeric band 1312 on its distal end (such as a Pebax band). [0606] As shown in FIGS.57A-57C, the extension portion 1302 of the first braided layer 1300 can surround the inner shaft 234 of the delivery apparatus. In some examples, the extension portion 1302 of the first braided layer 1300 can be spaced away from (in a radial direction) the outer wall or surface of the inner shaft 234. [0607] The inner shaft 234, and any other inner shaft of a delivery apparatus described herein, can form a lumen configured to receive a guidewire, over which the delivery apparatus is guided in route to a target implantation site. [0608] In some examples, the extension portion 1302 of the first braided layer 1300 can be necked or tapered down to the inner shaft 234, such that at least a segment of the extension portion 1302 can be in contact with an outer surface of the inner shaft 234. For example, as shown in FIGS.58-59B, the extension portion 1302 of the first braided layer 1300 extends distally out from the distal end of the polymeric jacket 1304 of the balloon shaft 226 and tapers radially inward, relative to a central longitudinal axis 1322 of the delivery apparatus, toward the inner shaft 234. [0609] A majority of the extension portion 1302 can extend along the inner shaft 234, in contact (e.g., face-to-face contact) with the inner shaft, to the inflatable balloon 228 (e.g., the proximal leg of the inflatable balloon, as shown in FIG.59B). [0610] In some examples, the extension portion 1302 can be crimped onto the outer surface of the inner shaft 234. [0611] The crimp balloon 225 surrounds the extension portion 1302. The extension portion 1302 can provide increased rigidity and support for receiving a prosthetic valve crimped thereon and for transferring torque from the balloon shaft 226 to the inflatable balloon 228. [0612] Gaps 1314 in the braid of the extension portion 1302 can allow inflation fluid to flow from a fluid lumen 1316 defined between the inner shaft 234 and the balloon shaft 226 (as shown in the cross-sectional view of FIG.58) into the crimp balloon 225, thereby allowing the crimp balloon 225 to at least partially inflate. [0613] In some examples, instead of the extension portion 1302 of the first braided layer 1300 extending underneath the crimp balloon 225, a braid of the inner shaft 234 can extend out of the inner shaft and radially outward to the balloon shaft 226, thereby rotationally fixing the balloon shaft 226 to the inflatable balloon 228 (and thus allowing effective torque transfer therebetween). For example, in such instances, the extension portion 1302 shown in FIGS. 59A and 59B can be an extension of a braided layer of the inner shaft 234 instead of the balloon shaft 226. [0614] In some examples, as shown in FIGS.59A and 59B, a polymeric sleeve 1318 can cover at least the portion or segment of the extension portion 1302 that contacts the inner surface of the inner shaft 234. As such, when a prosthetic valve is crimped onto the crimp balloon 225 over this region, the crimp balloon 225 is protected from directly contacting the braid of the extension portion 1302. [0615] In some examples, as shown in FIGS.60-61B, a stepped braided layer 1320 (or “braided tube 1320”) can extend from within the balloon shaft 226 (e.g., from within the polymeric jacket 1304) to the inner shaft 234. The stepped braided layer 1320 can be configured to effectively transfer torque from the balloon shaft 226 to the inflatable balloon 228. In some examples, the stepped braided layer 1320 can extend to a proximal leg of the inflatable balloon. For example, the stepped braided layer 1320 can be used in lieu of the tube 229 in FIG.45. [0616] For example, the stepped braided layer 1320 can comprise a first portion 1324 having a first diameter 1330 and arranged primarily inside the polymeric jacket 1304 of the balloon shaft 226, and a second portion 1325 having a second diameter 1332 and arranged along the outer surface of the inner shaft 234, the second diameter being smaller than the first diameter. The stepped braided layer 1320 can further comprise a transition portion 1328 that extends between and steps down from the larger diameter first portion 1324 to the smaller diameter second portion 1325. [0617] In some examples, the transition portion 1328 is relative perpendicular to the central longitudinal axis 1322. [0618] In some examples, the transition portion 1328 is angled relative to the central longitudinal axis 1322 and a line perpendicular to the central longitudinal axis 1322. [0619] In some examples, the second diameter 1332 is the same or slightly larger than an outer diameter of the inner shaft 234. [0620] In some examples, the second portion 1325 contacts and/or is crimped to the outer surface of the inner shaft 234. [0621] In some examples, the second portion 1325 is spaced away, by a small amount, from the inner shaft 234 such that there is a fluid gap therebetween. [0622] As shown in FIG.61B, the crimp balloon 225 extends over and around the second portion 1325 and transition portion 1328 of the stepped braided layer 1320. [0623] Gaps 1336 in the braid of the stepped braided layer 1320 can allow inflation fluid to flow from a fluid lumen 1316 defined between the inner shaft 234 and the balloon shaft 226 (as shown in the cross-sectional view of FIG.60) into the crimp balloon 225, thereby allowing the crimp balloon 225 to at least partially inflate. [0624] In some examples, as shown in FIG.61B, a polymeric sleeve 1334 can cover all or most of the second portion 1325 of the stepped braided layer 1320 (or at least the portion configured to receive the prosthetic valve thereon). As such, when a prosthetic valve is crimped onto the crimp balloon 225 over the second portion 1325 of the stepped braided layer 1320, the crimp balloon 225 is protected from directly contacting the braid of the second portion 1325. [0625] FIGS.62 and 63 show examples of support structures for a crimp balloon, such as crimp balloon 225, that can be arranged over or underneath the crimp balloon. The support structure can provide a more rigid structure along the crimp balloon that allows a prosthetic valve to be radially compressed thereon and allows for effective torque transfer from the balloon shaft to the inflatable balloon. [0626] FIG.62 shows an exemplary support structure 1400 (which can also be referred to as a “frame”) arrange around (over) the crimp balloon 225, where the crimp balloon 225 is coupled to the balloon shaft 226. The crimp balloon 225 further extends to the inflatable balloon, as explained herein (e.g., as shown in FIGS.5B and 45, and as shown in FIG.63, as described further below). [0627] As shown in FIG.62, the support structure 1400 comprises two rings 1402 defining opposing ends of the support structure 1400 and a plurality of longitudinally extending struts 1404 (or supports or support struts) extending between the two rings 1402. The struts are spaced circumferentially apart from one another around the support structure 1400. [0628] While three struts 1404 are shown in FIG.62, other numbers of struts are possible, such as two, four, five, or the like. [0629] The struts 1404 can having varying widths (in the circumferential direction) and/or thicknesses (in the radial direction). [0630] Additionally, in some examples, instead of the wider struts 1404 shown in FIG.62, in some examples, each strut 1404 can be replaced by a bundle of two or more thinner wires, which together form a relatively rigid support strut. [0631] In some examples, the struts 1404 can comprise metal. [0632] In some examples, the entire support structure 1400 comprises metal. [0633] In some examples, the metal is a shape-memory metal, such as Nitinol. [0634] In some examples, the support structure is bonded to an exterior surface of the crimp balloon. [0635] In some examples, the two rings 1402 are crimped or otherwise coupled around the distal end of the balloon shaft 226 and the proximal leg of the inflatable balloon, respectively. [0636] FIG.63 shows an exemplary support structure 1410 which is similar to the support structure 1400 but comprises a plurality of longitudinally extending struts 1412 (which can be the same or similar to struts 1404) that are spaced circumferentially apart around the outer surface of the crimp balloon 225 and are wrapped together at their opposing ends by coiled wires 1414. [0637] In some examples, the coiled wires 1414 can be wrapped around an interface between the crimp balloon 225 and the balloon shaft 226 and the crimp balloon 225 and the inflatable balloon 228. [0638] In this way the support structures 1400 and 1410 can form an exoskeleton for the crimp balloon. [0639] In some examples, at least the struts 1404 and the struts 1412 can comprise a more flexible metal, or a shape memory metal (as described above) to allow for radial compression (when crimping a prosthetic valve thereon) and/or to allow the crimp balloon 225 to at least partially inflate. [0640] The struts 1404 and 1412 can provide rails that enable easier translation of the prosthetic valve from its location on the crimp balloon to the inflatable balloon. [0641] In some examples, the support structures 1400 and 1410 can be arranged underneath the crimp balloon. In some examples, the one or more support struts 1404 or 1410 can be bonded to an inner surface of the crimp balloon 225. [0642] In some examples, a proximal end of the support structures 1400 or 1410 can be relatively thin such that it fits within the outer shaft of the delivery apparatus (e.g., outer shaft 222). [0643] Instead of longitudinally extending struts 1404, 1412, in some examples, a support structure for a crimp balloon can comprise struts in various orientations, such as circumferentially extending struts, helically extending struts, longitudinally extending struts, or combinations thereof. [0644] In some examples, a support structure for a crimp balloon can comprise more than two rings 1402, such as a third ring positioned between the two outer rings 1402 of FIG.62. [0645] In some examples, the crimp balloon can be replaced by smaller diameter section or segment of the balloon shaft that is configured to receive a radially compressed prosthetic valve directly thereon. In this way, the balloon shaft can extend all the way to the inflatable balloon (e.g., inflatable balloon 228) and comprise one or more larger diameter segments and a smaller diameter segment configured to receive the prosthetic valve. [0646] The balloon shaft can be the same or similar to the balloon shafts described herein, such as balloon shaft 226. For example, as described above with reference to FIGS.57A, 58, and 60, the balloon shaft can comprise a polymeric jacket and one or more braided layers embedded therein. [0647] For example, as shown in FIGS.64-65B, a balloon shaft 1500 can comprise a main segment 1502 that can extend from a handle of the delivery apparatus, through an outer shaft of the delivery apparatus (similar to the balloon shaft 226 of FIGS.2-5B) and a smaller diameter segment 1504 that has a second diameter 1510 that is smaller than a first diameter 1508 of the main segment 1502. The smaller diameter segment 1504 is configured to receive the prosthetic valve thereon, in a radially compressed configuration. The smaller, second diameter 1510 of the segment 1504 helps to reduce an overall crimp profile of the prosthetic valve when radially compressed thereon, thereby reducing push forces of the delivery apparatus when navigating through a patient’s vasculature. [0648] In some examples, the balloon shaft 1500 comprises a relatively short, larger diameter segment 1506 that has a third diameter 1512. The third diameter 1512 is larger than the second diameter 1510. [0649] In some examples, the third diameter 1512 is the same as the first diameter 1508 of the of the main segment 1502. [0650] In some examples, the first diameter 1508 is in a range of 3.5-4.3 mm and the second diameter 1510 is in a range of 2.5-3.3 mm. [0651] In some examples, the main segment 1502 and the larger diameter segment 1506 have the same composition (e.g., a same thickness of polymeric jacket, a same thickness and numbers of braided layers, and/or the like). [0652] In some examples, the smaller diameter segment 1504 can have the same composition as the main segment 1502, such as the same number of braided layers and components therebetween. However, the smaller diameter segment 1504 can have a thinner polymeric jacket, thereby reducing the overall diameter of the smaller diameter segment 1502 relative to the main segment 1502. [0653] In some examples, the smaller diameter segment 1504 can have a narrower braided layer than that of the main segment 1502, thereby reducing the diameter of the smaller diameter segment 1502 relative to the main segment 1502. [0654] In some examples, the smaller diameter segment 1504 can have a first braided layer and the main segment 1502 can comprise the first braided layer and a second braided layer, thereby reducing the diameter of the smaller diameter segment 1502 relative to the main segment 1502. [0655] As shown in FIG.65B, in some examples, the balloon shaft 1500 can comprise tapered regions 1514 that provide smoother transitions between the smaller diameter segment 1504 and each of the main segment 1502 and the larger diameter segment 1506. [0656] In some examples, the balloon shaft may not include the larger diameter segment 1506, and instead includes the main segment 1502 and the smaller diameter segment 1504 that extends to the inflatable balloon 228, as shown in FIG.66. [0657] In some examples, the polymeric jacket of the smaller diameter segment 1504 can comprise a Pebax that is softer, or has a lower durometer, than that of the main segment 1502, thereby providing the smaller diameter segment 1504 with increased flexibility and compressibility in the radial direction (for when the prosthetic valve is radially compressed directly thereon, without any intervening components therebetween). [0658] In some examples, instead of one or more braided layers, the balloon shaft 1500, including both the main segment 1502 and the smaller diameter segment 1504 can comprise a hypotube (e.g., a metal hypotube). As a result, the smaller diameter segment 1504 can have increased rigidity. In some examples, this can result in more effective torque transfer along the smaller diameter segment 1504, from the main segment 1502 of the balloon shaft 1500 to the inflatable balloon 228. [0659] For example, FIGS.67-69 depict an example of a balloon shaft 1600 for a delivery apparatus that comprises a metal tube 1602 that is configured to flex or bend as the delivery navigates curves in a patient’s vasculature, and transfer torque to the inflatable balloon to allow for rotational alignment of a prosthetic valve mounted on a distal end portion of the delivery apparatus. [0660] The balloon shaft 1600 can extend from a proximal portion of the delivery apparatus (for example, proximal portion 224 of delivery apparatus 200 depicted in FIG.2) to the inflatable balloon (for example, the proximal leg 231 of the inflatable balloon 228). In some examples, the balloon shaft 1600 can be used in lieu of the balloon shaft 226 and the crimp balloon 225 in the delivery apparatus 200. [0661] In some examples, the metal tube 1602 comprises stainless steel. In some examples, the metal tube 1602 is a hypotube. [0662] In some examples, the metal tube 1602 comprises Nitinol. [0663] In some examples, the metal tube 1602 has a constant diameter along is length. In some examples, the diameter of the metal tube 1602 is less than 3 mm. [0664] The wall of the metal tube 1602 is denser that the metal braids of the balloon shafts and tubes described herein. As such, it may provide better torque transfer along its length. [0665] In some examples, the metal tube 1602 comprises a plurality of cuts 1604 (or slits) along at least a portion of its length that enables the metal tube 1602 to flex or bend. FIGS. 67 and 68 depict one exemplary pattern for the cuts 1604. In this example, the cuts 1604 are circumferentially extending and spaced apart from one another in both the circumferential direction and the axial direction. Cuts 1604 in adjacent rows (which are axially spaced) are circumferentially offset from one another. [0666] The cuts 1604 can extend through an entire thickness of the metal tube 1602. Said another way, the cuts 1604 can each extend through the wall of the metal tube 1602. [0667] The metal tube 1602 can comprise cuts in a variety of patterns and shapes. For example, FIG.69 shows a portion of the metal tube 1602 with diamond shaped cuts 1610 in a similar pattern to that shown in FIGS.67 and 68. A variety of other cut patterns and shapes are possible, such as any of those shown and described herein (for example, as shown in FIGS.15 and 19-25) [0668] In some examples, the cuts 1604 can extend along a majority of the length of the metal tube 1602. [0669] In some examples, the cuts 1604 can extend along a distal end portion of the metal tube 1602 which experiences the most bending as it navigates a patient’s vasculature. [0670] As shown in FIGS.67 and 68, in some examples, a distal end portion 1606 of the metal tube 1602 can comprise one or more apertures 1608 configured to allow a reflowed polymer to pass therethrough, thereby enhancing bonding between the metal tube 1602 and one or more polymer layers over or underneath the distal end portion 1606. [0671] For example, the balloon shaft 1600 can, in some cases, comprise a thin outer polymer layer 1612 (as depicted in FIG.68). For example, the outer polymer layer 1612 can have a wall thickness in a range of 0.0127 mm (0.0005 inches) to 0.127 mm (0.005 inches) or 0.026 mm (0.001 inches) to 0.127 mm (0.005 inches). [0672] In some examples, the outer polymer layer 1612 comprises PEBAX. In some examples, the outer polymer layer is a PEBAX heat shrink layer that bonds to an outer surface of the metal tube 1602 and within the apertures 1608 upon application of heat. [0673] The outer polymer layer 1612 is configured to bond to the proximal leg 231 of the inflatable balloon 228, as shown in FIG.68. As a result, the distal end portion of the balloon shaft 1600 is bonded to the inflatable balloon 228. [0674] In addition to being torqueable and flexible/bendable, the balloon shaft 1600 may be easier and cheaper to manufacture than traditional balloon shafts comprising one or more braided layers and multiple polymer layers of varying durometer. For example, the balloon shaft 1600 comprises fewer components than traditional balloon shafts and the flexibility of the balloon shaft 1600 can be controlled by adjusting the material properties of the metal tube 1602 and/or the shape or pattern of the cuts 1604 in the metal tube 1602 (instead of utilizing multiple polymer layers of different durometers along a length of the shaft, which can be difficult and timely to produce). As a result, both material and labor costs for manufacturing the balloon shaft 1600 may be reduced (relative to more traditional balloon shafts). [0675] The various shafts described herein that extend between a balloon shaft and an inflatable balloon of a delivery apparatus (such as shafts 300, 350, 400, 500, 600, 620, 700, 800, 810, 820, 830, 840, 1108, 1302, 1325, 1400, 1410, 1504, 1600, 1700 and/or proximal balloon legs 906, 1006, and 1206) can provide a more rigid structure on which to mount a prosthetic valve in a radially compressed state and are able to effectively transfer torque from the balloon shaft to the inflatable balloon of the delivery apparatus (without any unwanted distortion to the delivery apparatus or movement of the distal end portion of the delivery apparatus). As a result, the prosthetic valve can be rotated on the delivery apparatus to orient it relative to the native anatomy prior to deployment. Furthermore, the cuts, openings, recesses, materials, and/or lumens in the various shafts described herein provide flexibility to the shaft so that the shaft can bend as the delivery apparatus navigates curves in a patient’s vasculature. In some examples, the various shafts described herein can be axially compressible, thereby enabling such shafts to extend underneath an inflatable balloon and shorten as the inflatable balloon inflates. [0676] In some examples, a method of delivering and deploying a prosthetic valve at an implantation site (e.g., a native aortic valve) is as follows. The prosthetic valve can be crimped on the distal end portion of a delivery apparatus at a location offset from the central portion of an inflatable balloon (e.g., balloon 228), such as on a crimp balloon (any crimp balloon disclosed herein), a proximal leg of a balloon (such as shown in FIGS.48-56B), or on a shaft extending from the balloon shaft to the inflatable balloon (such as shown in FIGS.6- 18, 26-27B, 35-47D, 57A-63, and 70) or from a proximal end portion of the delivery apparatus to the inflatable balloon (such as shown in FIGS.64-68). After valve crimping, the distal end portion of the delivery apparatus (along with the prosthetic valve) is inserted into the patient’s vasculature. In some examples, the distal end portion of the delivery apparatus (along with the prosthetic valve) is inserted through an introducer sheath previously inserted into a vessel (such as a femoral artery) and into the vasculature. [0677] Once inside the patient’s vasculature, the prosthetic valve can be repositioned onto the central portion of the inflatable balloon, such as by moving the shaft 222 distally relative to the balloon shaft (e.g., shaft 226) and/or moving the balloon shaft proximally relative to the shaft 222, as previously described. Repositioning of the prosthetic valve can occur, for example, within the descending aorta or the ascending aorta. After repositioning the prosthetic valve, the delivery apparatus can be advanced to position the prosthetic valve near the intended implantation site. For example, when implanting the prosthetic valve within the native aortic valve, the prosthetic valve can be positioned within the ascending aorta downstream the native aortic valve. At this time, the delivery apparatus can be rotated to produce rotation of the prosthetic valve and achieve rotational alignment of the prosthetic valve with a location or landmark of the native anatomy. Rotation of the prosthetic valve can be accomplished by locking or fixing the balloon shaft (e.g., shaft 226) and the inner shaft 234 against rotation relative to the handle portion (such as by actuating securement mechanism 298) and the rotating the handle portion 220, which in turn rotates the balloon shaft 226, the inner shaft 234, the balloon 228, and the prosthetic valve. Alternatively, the prosthetic valve can be rotated by gripping and rotating a proximal end portion of the balloon shaft 226 or proximal portion 224, which is effective to rotate the balloon shaft 226, the inner shaft 234, the balloon 228, and the prosthetic valve. Various imaging techniques can used to rotationally align the prosthetic valve with respect to the native annulus. Further details of methods and devices for rotationally aligning a prosthetic valve with respect to the native annulus are disclosed in PCT Patent Publication Nos. WO 2022/046585 and WO 2024/015267, which are incorporated by reference herein in their entireties. [0678] Following rotational alignment of the prosthetic valve, the delivery apparatus can be further advanced to position the prosthetic valve within the native aortic annulus (or other implantation site) and the balloon is inflated to deploy the prosthetic valve. Delivery Techniques [0679] For implanting a prosthetic valve within the native aortic valve via a transfemoral delivery approach, the prosthetic valve is mounted in a radially compressed state along the distal end portion of a delivery apparatus. The prosthetic valve and the distal end portion of the delivery apparatus are inserted into a femoral artery and are advanced into and through the descending aorta, around the aortic arch, and through the ascending aorta. The prosthetic valve is positioned within the native aortic valve and radially expanded (e.g., by inflating a balloon, actuating one or more actuators of the delivery apparatus, or deploying the prosthetic valve from a sheath to allow the prosthetic valve to self-expand). Additionally and/or alternatively, a prosthetic valve can be implanted within the native aortic valve in a transapical procedure, whereby the prosthetic valve (on the distal end portion of the delivery apparatus) is introduced into the left ventricle through a surgical opening in the chest and the apex of the heart and the prosthetic valve is positioned within the native aortic valve. Additionally and/or alternatively, in a transaortic procedure, a prosthetic valve (on the distal end portion of the delivery apparatus) is introduced into the aorta through a surgical incision in the ascending aorta, such as through a partial J-sternotomy or right parasternal mini-thoracotomy, and then advanced through the ascending aorta toward the native aortic valve. [0680] For implanting a prosthetic valve within the native mitral valve via a transseptal delivery approach, the prosthetic valve is mounted in a radially compressed state along the distal end portion of a delivery apparatus. The prosthetic valve and the distal end portion of the delivery apparatus are inserted into a femoral vein and are advanced into and through the inferior vena cava, into the right atrium, across the atrial septum (through a puncture made in the atrial septum), into the left atrium, and toward the native mitral valve. Additionally and/or alternatively, a prosthetic valve can be implanted within the native mitral valve in a transapical procedure, whereby the prosthetic valve (on the distal end portion of the delivery apparatus) is introduced into the left ventricle through a surgical opening in the chest and the apex of the heart and the prosthetic valve is positioned within the native mitral valve. [0681] For implanting a prosthetic valve within the native tricuspid valve, the prosthetic valve is mounted in a radially compressed state along the distal end portion of a delivery apparatus. The prosthetic valve and the distal end portion of the delivery apparatus are inserted into a femoral vein and are advanced into and through the inferior vena cava, and into the right atrium, and the prosthetic valve is positioned within the native tricuspid valve. A similar approach can be used for implanting the prosthetic valve within the native pulmonary valve or the pulmonary artery, except that the prosthetic valve is advanced through the native tricuspid valve into the right ventricle and toward the pulmonary valve/pulmonary artery. [0682] Another delivery approach is a transatrial approach whereby a prosthetic valve (on the distal end portion of the delivery apparatus) is inserted through an incision in the chest and an incision made through an atrial wall (of the right or left atrium) for accessing any of the native heart valves. Atrial delivery can also be made intravascularly, such as from a pulmonary vein. Still another delivery approach is a transventricular approach whereby a prosthetic valve (on the distal end portion of the delivery apparatus) is inserted through an incision in the chest and an incision made through the wall of the right ventricle (typically at or near the base of the heart) for implanting the prosthetic valve within the native tricuspid valve, the native pulmonary valve, or the pulmonary artery. [0683] In all delivery approaches, the delivery apparatus can be advanced over a guidewire previously inserted into a patient’s vasculature. Moreover, the disclosed delivery approaches are not intended to be limited. Any of the prosthetic valves disclosed herein can be implanted using any of various delivery procedures and delivery devices known in the art. [0684] Any of the systems, devices, apparatuses, etc. herein can be sterilized (for example, with heat/thermal, pressure, steam, radiation, and/or chemicals, etc.) to ensure they are safe for use with patients, and any of the methods herein can include sterilization of the associated system, device, apparatus, etc. as one of the steps of the method. Examples of heat/thermal sterilization include steam sterilization and autoclaving. Examples of radiation for use in sterilization include, without limitation, gamma radiation, ultra-violet radiation, and electron beam. Examples of chemicals for use in sterilization include, without limitation, ethylene oxide, hydrogen peroxide, peracetic acid, formaldehyde, and glutaraldehyde. Sterilization with hydrogen peroxide may be accomplished using hydrogen peroxide plasma, for example. Additional Examples of the Disclosed Technology [0685] In view of the above-described implementations of the disclosed subject matter, this application discloses the additional examples enumerated below. It should be noted that one feature of an example in isolation or more than one feature of the example taken in combination and, optionally, in combination with one or more features of one or more further examples are further examples also falling within the disclosure of this application. [0686] Example 1. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft having a first end coupled to the distal end of the first shaft, wherein a proximal end of the inflatable balloon is coupled to the third shaft, wherein the third shaft comprises a plurality of openings or cuts along its length that allows it to bend, and wherein the third shaft is configured to transfer torque from the first shaft to a second end of the third shaft when the first shaft is rotated. [0687] Example 2. The delivery apparatus of any example herein, particularly example 1, wherein the plurality of openings or cuts extend in a radial direction through at least a portion of a thickness of the third shaft, the thickness defined between a radially outward facing surface and a radially inward facing surface of the third shaft. [0688] Example 3. The delivery apparatus of any example herein, particularly either example 1 or example 2, further comprising a crimp balloon extending along the third shaft, and wherein the second shaft extends through the inside of the crimp balloon. [0689] Example 4. The delivery apparatus of any example herein, particularly example 3, wherein the third shaft is arranged inside the crimp balloon. [0690] Example 5. The delivery apparatus of any example herein, particularly example 3, wherein the third shaft is arranged over and surrounds the crimp balloon. [0691] Example 6. The delivery apparatus of any example herein, particularly any one of examples 1-5, wherein the second end of the third shaft is coupled to the proximal end of the inflatable balloon, the second end arranged opposite the first end of the third shaft. [0692] Example 7. The delivery apparatus of any example herein, particularly example 6, wherein the second end of the third shaft comprises axially extending struts that are spaced circumferentially apart around the second end and that flare outward from a body of the third shaft. [0693] Example 8. The delivery apparatus of any example herein, particularly example 7, wherein the proximal end of the inflatable balloon comprises a plurality of holes, and wherein each axially extending strut includes an arrow-shaped tip that is inserted into a respective hole of the plurality of holes to couple the second end of the third shaft to the proximal end of the inflatable balloon. [0694] Example 9. The delivery apparatus of any example herein, particularly example 8, wherein the proximal end of the inflatable balloon and the second end of the third shaft are bonded together by a polymer reflowed over the axially extending struts coupled to the holes of the inflatable balloon. [0695] Example 10. The delivery apparatus of any example herein, particularly example 6, wherein the second end of the third shaft comprises distal struts that are spaced circumferentially apart around the second end, wherein each distal strut flares outward from a body of the third shaft and curves in a circumferential direction. [0696] Example 11. The delivery apparatus of any example herein, particularly example 10, wherein each distal strut has one or more holes at its distal end and is coupled to the proximal end of the inflatable balloon, and wherein the distal struts and proximal end of the inflatable balloon are bonded together by a polymer that is reflowed over the distal struts, over the proximal end of the inflatable balloon, and through the one or more holes in the distal struts. [0697] Example 12. The delivery apparatus of any example herein, particularly any one of examples 1-5, wherein the second end of the third shaft is coupled to a polymeric body that is mounted on a distal end of the second shaft, wherein the second end is arranged opposite the first end of the third shaft. [0698] Example 13. The delivery apparatus of any example herein, particularly example 12, wherein a distal end of the inflatable balloon is coupled to the polymeric body. [0699] Example 14. The delivery apparatus of any example herein, particularly either example 12 or example 13, wherein the polymeric body is a distal shoulder. [0700] Example 15. The delivery apparatus of any example herein, particularly any one of examples 12-14, wherein the second end of the third shaft is bonded to the polymeric body by a polymer that is reflowed over the second end of the third shaft and the distal shoulder. [0701] Example 16. The delivery apparatus of any example herein, particularly any one of examples 1-15, wherein the first end of the third shaft comprises proximal struts that are spaced circumferentially apart around the first end and that flare outward from a body of the third shaft and spiral along the distal end of the first shaft, wherein each proximal strut clamps to an outer surface of the distal end of the first shaft. [0702] Example 17. The delivery apparatus of any example herein, particularly example 16, wherein each proximal strut includes an aperture in its attached end, the attached end connecting to the body of the third shaft, and wherein the aperture is configured to provide strain relief to the proximal strut. [0703] Example 18. The delivery apparatus of any example herein, particularly any one of examples 1-17, wherein the plurality of openings or cuts in the third shaft form a plurality of circumferentially extending rows of cuts that are spaced axially apart from one another. [0704] Example 19. The delivery apparatus of any example herein, particularly example 18, wherein each row of cuts comprises a continuous cut that forms spaced apart projections on both sides of the cut, wherein the projections on opposite sides of the cut alternate with one another such that the projections on the opposite sides of the cut fit together like puzzle pieces with a gap therebetween. [0705] Example 20. The delivery apparatus of any example herein, particularly example 18, wherein each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the third shaft, and wherein each individual cut is a circumferential cut. [0706] Example 21. The delivery apparatus of any example herein, particularly claim 20, wherein each individual cut is a circumferential cut with apertures at its opposing ends, wherein the apertures are wider than a width of a body of the individual cut. [0707] Example 22. The delivery apparatus of any example herein, particularly either example 20 or example 21, wherein the individual cuts in adjacent rows of cuts are staggered such that individuals cut in a first row are circumferentially offset from individual cuts in a second row that is adjacent to the first row. [0708] Example 23. The delivery apparatus of any example herein, particularly any one of examples 1-17, wherein the plurality of openings or cuts in the third shaft are formed by a plurality of interconnected struts that define a plurality of open cells that form a diamond lattice structure. [0709] Example 24. The delivery apparatus of any example herein, particularly example 23, wherein the third shaft comprises alternating sections of the diamond lattice structure, the alternating sections including a first section comprising cells with a long dimension extending in an axial direction and a second section comprising cells with a long dimension extending in a circumferential direction, wherein the first section is directly connected to the second section. [0710] Example 25. The delivery apparatus of any example herein, particularly example 24, wherein each second section is configured to bend about a central longitudinal axis of the delivery apparatus, and wherein each first section is configured to compress in a radial direction which is defined relative to the central longitudinal axis. [0711] Example 26. The delivery apparatus of any example herein, particularly any one of examples 1-25, wherein the third shaft comprises metal. [0712] Example 27. The delivery apparatus of any example herein, particularly any one of examples 1-26, wherein the third shaft comprises Nitinol. [0713] Example 28. The delivery apparatus of any example herein, particularly any one of examples 1-27, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another. [0714] Example 29. The delivery apparatus of any example herein, particularly example 28, wherein the third shaft is coaxial with the first and second shafts. [0715] Example 30. The delivery apparatus of any example herein, particularly either example 28 or example 29, further comprising a fourth shaft that extends distally from the handle and surrounds the first shaft, wherein the first shaft extends distal to a distal end of the fourth shaft, and wherein the handle comprises an adjustment mechanism configured to adjust a curvature of a distal end portion of the fourth shaft. [0716] Example 31. An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 1-30, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft. [0717] Example 32. The assembly of any example herein, particularly example 31, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve. [0718] Example 33. The assembly of any example herein, particularly example 32, wherein the fourth shaft is steerable and configured to flex about a central longitudinal axis of the delivery apparatus. [0719] Example 34. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft comprising metal and having a first end coupled to the distal end of the first shaft, wherein a proximal end of the inflatable balloon is coupled to the third shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft comprises a plurality of repeating cuts spaced apart along the third shaft. [0720] Example 35. The delivery apparatus of any example herein, particularly example 34, further comprising a crimp balloon extending along the third shaft. [0721] Example 36. The delivery apparatus of any example herein, particularly example 35, wherein the third shaft is arranged inside the crimp balloon. [0722] Example 37. The delivery apparatus of any example herein, particularly example 35, wherein the third shaft is arranged over and surrounds the crimp balloon. [0723] Example 38. The delivery apparatus of any example herein, particularly any one of examples 34-37, wherein the third shaft comprises a first section and a second section, the first section comprising a first portion of the plurality of repeating cuts defining a first cut pattern and the second section comprising a second portion of the plurality of repeating cuts defining a second cut pattern. [0724] Example 39. The delivery apparatus of any example herein, particularly example 38, wherein the first section extends distally from the distal end of the first shaft, and wherein the second section extends distally from a distal end of the first section and underneath the inflatable balloon. [0725] Example 40. The delivery apparatus of any example herein, particularly either example 38 or example 39, wherein the first portion of the plurality of repeating cuts are a plurality of circumferentially extending cuts that are spaced axially apart along the third shaft, and wherein each circumferentially extending cut forms a plurality of alternating projections in the third shaft that interlock with one another around the third shaft and allow the first section to bend and compress in the axial direction. [0726] Example 41. The delivery apparatus of any example herein, particularly any one of examples 38-40, wherein the second portion of the plurality of repeating cuts are a plurality of circumferentially extending rows of cuts, wherein each row of cuts comprises a plurality of circumferential cuts that are spaced apart around the third shaft. [0727] Example 42. The delivery apparatus of any example herein, particularly example 41, wherein each circumferential cut comprises two end portions and a body extending between the two end portions, wherein each end portion is wider than the body of the circumferential cut. [0728] Example 43. The delivery apparatus of any example herein, particularly either example 41 or example 42, wherein the circumferential cuts in adjacent rows of cuts are staggered such that at least a portion a body of a first circumferential cut in a first row is non- overlapping with a body of a second circumferential cut in an adjacent, second row, and wherein an end portion of the first cut and an end portion of the second cut overlap in an axial direction. [0729] Example 44. The delivery apparatus of any example herein, particularly any one of examples 34-43, wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon, the second end arranged opposite the first end of the third shaft. [0730] Example 45. The delivery apparatus of any example herein, particularly any one of examples 34-43, further comprising a polymeric body mounted on a distal end of the second shaft, wherein a distal end of the inflatable balloon is coupled to the polymeric body, and wherein a second end of the third shaft is coupled to the polymeric body. [0731] Example 46. The delivery apparatus of any example herein, particularly example 45, wherein the third shaft extends through and inside of the inflatable balloon to the polymeric body, wherein plurality of repeating cuts include a plurality of cuts that are spaced axially apart and each extend around a circumference of the shaft, and wherein each cut of the plurality of cuts defines a repeating puzzle-shaped pattern in the third shaft that allows the third shaft to compress axially. [0732] Example 47. The delivery apparatus of any example herein, particularly either example 45 or example 46, wherein the polymeric body is a distal shoulder. [0733] Example 48. The delivery apparatus of any example herein, particularly any one of examples 34-47, wherein the plurality of repeating cuts includes a plurality of circumferentially extending cuts that are spaced axially apart along the third shaft, and wherein each circumferentially extending cut forms a plurality of alternating projections around the third shaft that interlock with one another and allow the third shaft to bend and compress in the axial direction. [0734] Example 49. The delivery apparatus of any example herein, particularly any one of examples 34-47, wherein the plurality of repeating cuts includes a plurality of circumferentially extending rows of cuts, wherein each row of cuts comprises a plurality of circumferential cuts that are spaced apart around the third shaft. [0735] Example 50. The delivery apparatus of any example herein, particularly example 49, wherein each circumferential cut comprises two end portions and a body extending between the two end portions, wherein each end portion is wider than the body of the circumferential cut. [0736] Example 51. The delivery apparatus of any example herein, particularly example 50, wherein each end portion is circular. [0737] Example 52. The delivery apparatus of any example herein, particularly either example 50 or example 51, wherein the circumferential cuts in adjacent rows of cuts are staggered such that at least a portion a body of a first circumferential cut in a first row is non- overlapping with a body of a second circumferential cut in an adjacent, second row, and wherein an end portion of the first cut and an end portion of the second cut overlap in an axial direction. [0738] Example 53. The delivery apparatus of any example herein, particularly any one of examples 34-52, wherein one or more of the first end and a second end of the third shaft comprises a plurality of struts that are spaced circumferentially apart around the one or more of the first end and second end and that flare outward from a body of the third shaft. [0739] Example 54. The delivery apparatus of any example herein, particularly example 53, wherein the first end of the third shaft comprises the plurality of struts, and wherein the plurality of struts clamp to an outer surface of the distal end of the first shaft. [0740] Example 55. The delivery apparatus of any example herein, particularly example 54, wherein the plurality of struts and the distal end of the first shaft are bonded together by a reflowed polymer surrounding the plurality of struts and the distal end of the first shaft. [0741] Example 56. The delivery apparatus of any example herein, particularly example 53, wherein the second end of the third shaft comprises the plurality of struts, and wherein the plurality of struts attaches to the proximal end of the inflatable balloon. [0742] Example 57. The delivery apparatus of any example herein, particularly any one of examples 53-56, wherein a free end portion of each strut of the plurality of struts spirals in a circumferential direction. [0743] Example 58. The delivery apparatus of any example herein, particularly example 57, wherein each strut includes an aperture in its attached end, the attached end connecting to the body of the third shaft, and wherein the aperture is configured to provide strain relief to the strut. [0744] Example 59. The delivery apparatus of any example herein, particularly any one of examples 53-58, wherein each strut includes one or more apertures in its free end that is configured to receive a polymer reflowed over the plurality of struts. [0745] Example 60. The delivery apparatus of any example herein, particularly any one of examples 34-59, wherein the metal is stainless steel. [0746] Example 61. The delivery apparatus of any example herein, particularly any one of examples 34-60, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another. [0747] Example 62. The delivery apparatus of any example herein, particularly example 61, wherein the third shaft is coaxial with the first and second shafts. [0748] Example 63. The delivery apparatus of any example herein, particularly either example 61 or example 62, further comprising a fourth shaft that extends distally from the handle and surrounds the first shaft, wherein the first shaft extends distal to a distal end of the fourth shaft, and wherein the handle comprises an adjustment mechanism configured to adjust a curvature of a distal end portion of the fourth shaft. [0749] Example 64. An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 34-63, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft. [0750] Example 65. The assembly of any example herein, particularly example 64, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve. [0751] Example 66. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a third shaft extending along the crimp balloon, wherein the third shaft has a first end coupled to the distal end of the first shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft comprises a plurality of interconnected struts that define a plurality of open cells. [0752] Example 67. The delivery apparatus of any example herein, particularly example 66, wherein at least a portion of the third shaft is compressible in a radial direction and configured to receive a prosthetic device thereon in a radially compressed configuration. [0753] Example 68. The delivery apparatus of any example herein, particularly either example 66 or example 67, wherein the plurality of open cells are diamond-shaped cells with a long dimension of the diamond-shaped cells extending in an axial direction relative to a central longitudinal axis of the delivery apparatus. [0754] Example 69. The delivery apparatus of any example herein, particularly any one of examples 66-68, wherein the third shaft comprises alternating first sections and second sections, wherein each first section comprises first cells of the plurality of opens cells having a long dimension extending in an axial direction, and wherein each second section comprises second cells of the plurality of open cells having a long dimension extending in a circumferential direction. [0755] Example 70. The delivery apparatus of any example herein, particularly example 69, wherein each second section is disposed between two adjacent first sections, and wherein struts defining the second cells of each second section are directly connected to struts defining the first cells of the two adjacent first sections. [0756] Example 71. The delivery apparatus of any example herein, particularly either example 69 or example 70, wherein each second section is configured to bend around a central longitudinal axis of the delivery apparatus, and wherein each first section is configured to compress in a radial direction which is defined relative to the central longitudinal axis. [0757] Example 72. The delivery apparatus of any example herein, particularly any one of examples 69-71, wherein one first section is coupled to the distal end of the balloon shaft, and wherein another first section is coupled to a proximal end portion of the inflatable balloon. [0758] Example 73. The delivery apparatus of any example herein, particularly any one of examples 69-72, wherein a length of each first section, as defined in the axial direction, is longer than a length of each second section. [0759] Example 74. The delivery apparatus of any example herein, particularly any one of examples 69-73, wherein one first section that is disposed between two second sections is sized to receive a radially compressed prosthetic device thereon. [0760] Example 75. The delivery apparatus of any example herein, particularly any one of examples 69-74, wherein the plurality of interconnected struts includes connecting struts that connect the first and second sections to one another. [0761] Example 76. The delivery apparatus of any example herein, particularly example 75, wherein the connecting struts comprise axially extending struts and Y-shaped struts that extend around a circumference of the third shaft at a junction between the first and second sections. [0762] Example 77. The delivery apparatus of any example herein, particularly any one of examples 66-76, wherein the plurality of interconnected struts comprises metal. [0763] Example 78. The delivery apparatus of any example herein, particularly example 77, wherein the metal is Nitinol. [0764] Example 79. The delivery apparatus of any example herein, particularly any one of examples 66-78, wherein the third shaft extends over the crimp balloon. [0765] Example 80. The delivery apparatus of any example herein, particularly example 79, wherein the third shaft is coated with a polymeric coating. [0766] Example 81. The delivery apparatus of any example herein, particularly any one of examples 66-78, wherein the third shaft extends underneath the crimp balloon. [0767] Example 82. The delivery apparatus of any example herein, particularly any one of examples 66-81, wherein a second end of the third shaft is coupled to a proximal end portion of the inflatable balloon, the second end disposed opposite the first end. [0768] Example 83. The delivery apparatus of any example herein, particularly any one of examples 66-81, wherein a second end of the third shaft is coupled to a polymeric body mounted on a distal end of the second shaft, the second end disposed opposite the first end, and wherein the third shaft extends through the inflatable balloon. [0769] Example 84. The delivery apparatus of any example herein, particularly any one of examples 66-83, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another. [0770] Example 85. The delivery apparatus of any example herein, particularly example 84, wherein the third shaft is coaxial with the first and second shafts. [0771] Example 86. The delivery apparatus of any example herein, particularly either example 84 or example 85, further comprising a fourth shaft that extends distally from the handle and surrounds the first shaft, wherein the first shaft extends distal to a distal end of the fourth shaft, and wherein the handle comprises an adjustment mechanism configured to adjust a curvature of a distal end portion of the fourth shaft. [0772] Example 87. An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 66-86, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft. [0773] Example 88. The assembly of any example herein, particularly example 87, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve. [0774] Example 89. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a third shaft extending along the crimp balloon, outside of the second shaft, and having a first end coupled to the distal end of the first shaft, wherein a proximal end of the inflatable balloon is coupled to the third shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft is configured to bend relative to a central longitudinal axis of the delivery apparatus. [0775] Example 90. The delivery apparatus of any example herein, particularly example 89, wherein the third shaft comprises metal. [0776] Example 91. The delivery apparatus of any example herein, particularly example 90, wherein the metal is stainless steel. [0777] Example 92. The delivery apparatus of any example herein, particularly example 90, wherein the metal is Nitinol. [0778] Example 93. The delivery apparatus of any example herein, particularly any one of examples 90-92, wherein the third shaft is laser cut to form a repeating pattern of cuts in the metal, along a majority of a length of the third shaft. [0779] Example 94. The delivery apparatus of any example herein, particularly example 93, wherein the repeating pattern of cuts includes a plurality of cuts spaced axially apart along the third shaft, wherein each cut extends around a circumference of the third shaft and forms spaced apart projections in the third shaft on both sides of the cut that fit together like puzzle pieces and allow the third shaft to compress in an axial direction. [0780] Example 95. The delivery apparatus of any example herein, particularly example 93, wherein the repeating pattern of cuts includes a plurality of circumferentially extending rows of cuts that are spaced axially apart along the third shaft, wherein each row comprises a plurality of circumferential cuts spaced circumferentially apart around the third shaft. [0781] Example 96. The delivery apparatus of any example herein, particularly example 95, wherein each circumferential cut comprises two end portions and a body extending between the two end portions, wherein the body is elongated relative to the two end portions. [0782] Example 97. The delivery apparatus of any example herein, particularly example 96, wherein each end portion is wider than a width of the body, the width defined in the axial direction. [0783] Example 98. The delivery apparatus of any example herein, particularly any one of examples 95-97, wherein the circumferential cuts of each row of cuts are staggered in the axial direction relative to the circumferential cuts in immediately adjacent rows of cuts. [0784] Example 99. The delivery apparatus of any example herein, particularly any one of examples 90-92, wherein the third shaft comprises a plurality of interconnected struts defining a plurality of open cells. [0785] Example 100. The delivery apparatus of any example herein, particularly example 99, wherein the plurality of open cells are diamond-shaped cells. [0786] Example 101. The delivery apparatus of any example herein, particularly either example 99 or example 100, wherein a first portion of cells of the plurality of open cells have a long dimension oriented in an axial direction relative to the central longitudinal axis and define one or more first sections of the third shaft, and wherein a second portion of cells of the plurality of open cells have a long dimension oriented in a circumferential direction. [0787] Example 102. The delivery apparatus of any example herein, particularly example 101, where the third shaft comprises at least three first sections and at least two second sections, and wherein each second section is disposed between two adjacent first sections. [0788] Example 103. The delivery apparatus of any example herein, particularly example 102, wherein one first section is coupled to the distal end of the first shaft, and wherein another first section is coupled to the proximal end of the inflatable balloon. [0789] Example 104. The delivery apparatus of any example herein, particularly any one of examples 101-103, wherein each second section is configured to bend relative to the central longitudinal axis of the delivery apparatus, and wherein each first section is configured to compress in a radial direction which is defined relative to the central longitudinal axis. [0790] Example 105. The delivery apparatus of any example herein, particularly any one of examples 89-104, further comprising a polymeric body mounted on a distal end of the second shaft, and wherein a distal end of the inflatable balloon is coupled to the polymeric body. [0791] Example 106. The delivery apparatus of any example herein, particularly example 105, wherein the polymeric body is a distal shoulder. [0792] Example 107. The delivery apparatus of any example herein, particularly either example 105 or example 106, wherein a second end of the third shaft is coupled to the polymeric body and extends underneath the inflatable balloon, wherein the second end is opposite the first end of the third shaft. [0793] Example 108. The delivery apparatus of any example herein, particularly any one of examples 89-106, wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon, wherein the second end is opposite the first end of the third shaft. [0794] Example 109. The delivery apparatus of any example herein, particularly any one of examples 89-108, wherein the first end of the third shaft comprises a plurality of struts that are spaced circumferentially apart around the first end and that flare outward from a body of the third shaft, wherein each strut of the plurality of struts couples to an outer surface of the distal end of the first shaft. [0795] Example 110. The delivery apparatus of any example herein, particularly example 109, wherein each strut includes an aperture in its attached end, the attached end connecting to the body of the third shaft, and wherein the aperture is configured to provide strain relief to the strut. [0796] Example 111. The delivery apparatus of any example herein, particularly either example 109 or example 110, wherein each strut includes at least one aperture that is positioned over the outer surface of the first shaft and configured to receive a reflowed polymer therethrough to bond the plurality of struts to the distal end of the first shaft. [0797] Example 112. The delivery apparatus of any example herein, particularly any one of examples 89-111, wherein a second end of the first shaft comprises a plurality of struts that are spaced circumferentially apart around the second end and that flare outward from a body of the third shaft, wherein the second end is opposite the first end of the third shaft. [0798] Example 113. The delivery apparatus of any example herein, particularly example 112, wherein the proximal end of the inflatable balloon comprises a plurality of holes, and wherein each axially extending strut includes an arrow-shaped tip that is inserted into a respective hole of the plurality of holes to couple the second end of the third shaft to the proximal end of the inflatable balloon. [0799] Example 114. The delivery apparatus of any example herein, particularly either example 112 or example 113, wherein a free end of each strut of the plurality of struts includes one or more apertures. [0800] Example 115. The delivery apparatus of any example herein, particularly any one of examples 112-114, wherein the proximal end of the inflatable balloon and the second end of the third shaft are bonded together by a polymer reflowed over the plurality of struts and the proximal end of the inflatable balloon. [0801] Example 116. The delivery apparatus of any example herein, particularly any one of examples 89-115, further comprising a handle, wherein each of the first shaft and the second shaft extend distally from the handle, and wherein the first and second shafts are coaxial with one another. [0802] Example 117. The delivery apparatus of any example herein, particularly example 116, wherein the third shaft is coaxial with the first and second shafts. [0803] Example 118. The delivery apparatus of any example herein, particularly either example 116 or example 117, further comprising a fourth shaft that extends distally from the handle and surrounds the first shaft, wherein the first shaft extends distal to a distal end of the fourth shaft, and wherein the handle comprises an adjustment mechanism configured to adjust a curvature of a distal end portion of the fourth shaft. [0804] Example 119. The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft comprises a plurality of spaced apart apertures along its length, and wherein the third shaft extends underneath the crimp balloon. [0805] Example 120. The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft is a coil spring, and wherein the third shaft extends underneath the crimp balloon. [0806] Example 121. The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft comprises a braided mesh body, and wherein the third shaft extends underneath the crimp balloon. [0807] Example 122. The delivery apparatus of any example herein, particularly example 89, wherein the third shaft comprises a polymer. [0808] Example 123. The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises a plurality of circumferentially and axially spaced apart apertures extending along the third shaft. [0809] Example 124. The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises an axially extending central lumen and a plurality of axially extending lumens that are offset from the central lumen, and wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon. [0810] Example 125. The delivery apparatus of any example herein, particularly example 122, wherein the third shaft comprises an axially extending central lumen and a plurality of axially spaced recesses extending radially away from the central lumen, and wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon. [0811] Example 126. The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shift is a braided layer that extends from within the first shaft. [0812] Example 127. The delivery apparatus of any example herein, particularly example 126, wherein the braided layer has a first portion that extends along a majority of a length of the first shaft and is embedded in a polymeric jacket of the first shaft, and a second portion that extends distal to a distal end of the polymeric jacket of the first shaft and defines the third shaft. [0813] Example 128. The delivery apparatus of any example herein, particularly example 127, wherein the second portion of the braided layer extends along an outer surface of the third shaft to a proximal end of the inflatable balloon. [0814] Example 129. The delivery apparatus of any example herein, particularly any one of examples 89-92, wherein the third shaft is a support structure bonded to a surface of the crimp balloon, wherein the support structure comprises a plurality of support struts extending along the crimp balloon. [0815] Example 130. The delivery apparatus of any example herein, particularly example 129, where the plurality of support struts is bonded to an outer surface of the crimp balloon. [0816] Example 131. The delivery apparatus of any example herein, particularly either example 129 or example 130, wherein the plurality of support struts includes a plurality of longitudinally extending struts that extend between opposing ends of the support structure. [0817] Example 132. An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 89-131, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft. [0818] Example 133. The assembly of any example herein, particularly example 132, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve. [0819] Example 134. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a coil extending underneath the crimp balloon. [0820] Example 135. The delivery apparatus of any example herein, particularly example 134, wherein the coil extends between the first shaft and the inflatable balloon. [0821] Example 136. The delivery apparatus of any example herein, particularly either example 134 or example 135, wherein the coil is a metal spring. [0822] Example 137. The delivery apparatus of any example herein, particularly any one of examples 134-136, wherein opposing end portions of the coil have a larger pitch than a main body of the coil. [0823] Example 138. The delivery apparatus of any example herein, particularly any one of examples 134-137, wherein a first end portion of the coil is arranged within a proximal leg of the inflatable balloon. [0824] Example 139. The delivery apparatus of any example herein, particularly example 138, wherein a first end portion of the crimp balloon is bonded to the proximal leg of the inflatable balloon, around the first end portion of the coil. [0825] Example 140. The delivery apparatus of any example herein, particularly any one of examples 134-139, wherein a second end portion of the coil is arranged within the distal end of the first shaft. [0826] Example 141. The delivery apparatus of any example herein, particularly example 140, wherein a second end portion of the crimp balloon is bonded to the distal end of the first shaft, around the second end portion of the coil. [0827] Example 142. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, wherein the inflatable balloon comprises an inflatable body and a proximal leg extending proximally from the inflatable body toward the distal end of the first shaft, wherein the proximal leg has a stiffness specified such that it can transfer torque along its length and bend. [0828] Example 143. The delivery apparatus of any example herein, particularly example 142, wherein the proximal leg extends to the distal end of the first shaft. [0829] Example 144. The delivery apparatus of any example herein, particularly either example 142 or example 143, wherein the proximal leg has a length that is sized to be longer than a radially compressed prosthetic device. [0830] Example 145. The delivery apparatus of any example herein, particularly any one of examples 142-144, wherein the stiffness of the proximal leg is greater than a stiffness of the inflatable body. [0831] Example 146. The delivery apparatus of any example herein, particularly any one of examples 142-145, wherein the proximal leg comprises a plurality of openings spaced apart along its length. [0832] Example 147. The delivery apparatus of any example herein, particularly example 146, wherein each opening of the plurality of openings extends in a radial direction from an outer surface of the proximal leg toward a central lumen of the proximal leg. [0833] Example 148. The delivery apparatus of any example herein, particularly either example 146 or example 147, wherein the plurality of openings is radially extending holes that extend between an outer surface of the proximal leg and a central lumen of the proximal leg. [0834] Example 149. The delivery apparatus of any example herein, particularly example 148, wherein the radially extending holes are arranged in a spiral pattern around the proximal leg, and wherein each hole is axially spaced apart from adjacent holes. [0835] Example 150. The delivery apparatus of any example herein, particularly either example 148 or example 149, further comprising a crimp balloon extending around the proximal leg and coupled between the distal end of the first shaft and the inflatable balloon. [0836] Example 151. The delivery apparatus of any example herein, particularly either example 146 or example 147, wherein the plurality of openings is a plurality of recesses spaced axially apart along a length of the proximal leg, and wherein each recess of the plurality of recesses extents from an outer surface of the proximal leg toward a central lumen of the proximal leg. [0837] Example 152. The delivery apparatus of any example herein, particularly example 151, further comprising a thin film covering the proximal leg. [0838] Example 153. The delivery apparatus of any example herein, particularly example 151, further comprising a thin polymeric sleeve covering the proximal leg. [0839] Example 154. The delivery apparatus of any example herein, particularly any one of examples 142-145, wherein the proximal leg comprises a plurality of longitudinal pleats. [0840] Example 155. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft having a first end coupled to the distal end of the first shaft and a second end coupled to a proximal end of the inflatable balloon, wherein the second shaft extends through a central lumen of the third shaft, and wherein the third shaft is fluidly sealed around its outer surface and has a plurality of internal lumens or recesses that enable the third shaft to bend. [0841] Example 156. The delivery apparatus of any example herein, particularly example 155, wherein the third shaft has a stiffness that enables it to transfer torque from the first shaft to the second end of the third shaft and radially compress. [0842] Example 157. The delivery apparatus of any example herein, particularly either example 155 or example 156, wherein the plurality of internal lumens or recesses is a plurality of lumens, and wherein each lumen of the plurality of lumens is radially offset from the central lumen and circumferentially offset from adjacent lumens of the plurality of lumens. [0843] Example 158. The delivery apparatus of any example herein, particularly example 157, wherein each lumen extends axially along the third shaft and has a circular cross-section. [0844] Example 159. The delivery apparatus of any example herein, particularly example 157, wherein each lumen extends axially along the third shaft and has a non-circular cross- section. [0845] Example 160. The delivery apparatus of any example herein, particularly either example 155 or example 156, wherein the plurality of internal lumens or recesses is a plurality of recesses, and wherein each recess of the plurality of recesses extends from the central lumen through the third shaft toward the outer surface of the third shaft. [0846] Example 161. The delivery apparatus of any example herein, particularly example 160, wherein each recess extends in a radial direction and is spaced axially apart from adjacent recesses. [0847] Example 162. The delivery apparatus of any example herein, particularly either example 160 or example 161, wherein each recess is an annular recess. [0848] Example 163. The delivery apparatus of any example herein, particularly any one of examples 155-162, wherein the third shaft comprises a polymer. [0849] Example 164. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a braided tube comprising a first portion extending within the first shaft and a second portion that extends outward from a distal end of the first shaft to a proximal end of the inflatable balloon, and wherein the second portion is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated. [0850] Example 165. The delivery apparatus of any example herein, particularly example 164, wherein the first portion extends within a majority of a length of the first shaft and is embedded in a polymeric jacket of the first shaft. [0851] Example 166. The delivery apparatus of any example herein, particularly example 164, wherein the first portion of the braided tube extends through a distal end portion of the first shaft, wherein the braided tube is a first braided tube, and wherein the first shaft comprises a second braided tube extending along a majority of a length of the first shaft. [0852] Example 167. The delivery apparatus of any example herein, particularly any one of examples 164-166, further comprising a crimp balloon extending along the second portion of the braided tube, and wherein the second shaft extends through the inside of the crimp balloon. [0853] Example 168. The delivery apparatus of any example herein, particularly example 167, wherein the second portion of the braided tube is arranged inside the crimp balloon. [0854] Example 169. The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second shaft extends through the second portion of the braided tube, and wherein the second portion of the braided tube is spaced apart from the second shaft. [0855] Example 170. The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second shaft extends through the second portion of the braided tube, and wherein the second portion of the braided tube tapers radially inward from the distal end of the first shaft to the second shaft and extends along and contacts an outer surface of the second shaft. [0856] Example 171. The delivery apparatus of any example herein, particularly example 170, wherein the second portion of the braided tube is crimped onto the second shaft, along a portion of the second shaft that extends between the balloon shaft and the inflatable balloon. [0857] Example 172. The delivery apparatus of any example herein, particularly example 171, further comprising a polymeric sleeve covering the second portion of the braided tube that is crimped onto the second shaft. [0858] Example 173. The delivery apparatus of any example herein, particularly any one of examples 164-168, wherein the second portion of the braided tube comprises a larger diameter segment extending outward from the distal end of the first shaft, a smaller diameter segment extending along the outer surface of the second shaft, and a stepped segment that transitions between the larger diameter segment and the smaller diameter segment. [0859] Example 174. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a support structure arranged along the crimp balloon, wherein the support structure comprises a plurality of spaced apart support struts extending along a surface of the balloon. [0860] Example 175. The delivery apparatus of any example herein, particularly example 174, wherein the support structure is bonded to an outer surface of the crimp balloon. [0861] Example 176. The delivery apparatus of any example herein, particularly example 174, wherein the support structure is bonded to an inner surface of the crimp balloon. [0862] Example 177. The delivery apparatus of any example herein, particularly any one of examples 174-176, wherein the support structure comprises metal. [0863] Example 178. The delivery apparatus of any example herein, particularly any one of examples 174-177, wherein the plurality of struts includes a plurality of longitudinally extending struts that are spaced circumferentially apart from one another. [0864] Example 179. The delivery apparatus of any example herein, particularly any one of examples 174-178, wherein the support structure comprises two rings defining opposite ends of the support structure, and wherein the plurality of struts extends between the two rings. [0865] Example 180. The delivery apparatus of any example herein, particularly any one of examples 174-178, wherein the support structure comprises coiled wires, and wherein ends of the plurality of supports struts are held together around the crimp balloon with the coiled wires. [0866] Example 181. A delivery apparatus for a prosthetic device, comprising a handle; a rotatable first shaft, wherein the first shaft has a first segment with a first diameter and a second segment with a second diameter that is smaller than the first diameter, wherein the first segment extends from the handle and defines a majority of a length of the first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft; wherein the second segment of the first shaft extends from the first segment toward a proximal end of the inflatable balloon and is configured to receive a prosthetic valve in a radially compressed configuration. [0867] Example 182. The delivery apparatus of any example herein, particularly example 181, wherein a proximal end of the inflatable balloon is attached to the second segment. [0868] Example 183. The delivery apparatus of any example herein, particularly example 181, wherein the first shaft further comprises a third segment with a third diameter that is larger than the second diameter, and wherein the third segment extends between the second segment and a proximal end of the inflatable balloon. [0869] Example 184. The delivery apparatus of any example herein, particularly any one of examples 181-183, wherein the first shaft comprises one or more braided layers embedded within a polymeric jacket, and wherein a thickness of the polymeric jacket of the second segment is smaller than a thickness of the polymeric jacket of the first segment. [0870] Example 185. An assembly comprising the delivery apparatus of any example herein, particularly any one of examples 181-184, and further comprising a prosthetic valve mounted directly onto the second segment in the radially compressed configuration. [0871] Example 186. A delivery apparatus for a prosthetic device, comprising a handle; a rotatable first shaft extending distally from the handle, wherein the first shaft is a metal tube comprising a plurality of cuts spaced axially and circumferentially apart along at least a portion of a total length of the first shaft, wherein the plurality of cuts is configured such that the first shaft is bendable; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, and wherein a proximal end portion of the inflatable balloon is bonded to a distal end portion of the first shaft. [0872] Example 187. The delivery apparatus of any example herein, particularly example 186, wherein each cut of the plurality of cuts extends through a wall of the metal tube. [0873] Example 188. The delivery apparatus of any example herein, particularly either example 186 or example 187, wherein the plurality of cuts in the first shaft forms a plurality of circumferentially extending rows of cuts that are spaced axially apart from one another. [0874] Example 189. The delivery apparatus of any example herein, particularly example 188, wherein each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the first shaft, and wherein each individual cut is an elongated diamond shaped cut with a major axis of the elongated diamond shaped cut extending in the circumferential direction. [0875] Example 190. The delivery apparatus of any example herein, particularly example 188, wherein each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the first shaft, and wherein each individual cut is a slit extending in the circumferential direction. [0876] Example 191. The delivery apparatus of any example herein, particularly any one of examples 186-190, wherein the plurality of cuts extends along a majority of the total length of the first shaft. [0877] Example 192. The delivery apparatus of any example herein, particularly any one of examples 186-191, wherein the plurality of cuts extends along the at least the portion of the total length first shaft but are spaced away from a distal end of the first shaft. [0878] Example 193. The delivery apparatus of any example herein, particularly any one of examples 186-192, wherein the distal end portion of the first shaft comprises a plurality of apertures extending radially through a wall of the metal tube, and wherein the plurality of apertures is configured to receive a reflowed polymer for bonding the first shaft to the inflatable balloon. [0879] Example 194. The delivery apparatus of any example herein, particularly any one of examples 186-193, further comprising a proximal portion disposed proximal to the handle, wherein the first and second shafts extend distally from the proximal portion and through the handle, and wherein the proximal portion is configured to receive inflation fluid for inflating the inflatable balloon. [0880] Example 195. The delivery apparatus of any example herein, particularly any one of examples 186-194, wherein a diameter of the metal tube is less than 3 mm. [0881] Example 196. The delivery apparatus of any example herein, particularly any one of examples 186-195, wherein the first shaft comprises an outer polymer layer bonded to an outer surface of the metal tube. [0882] Example 197. The delivery apparatus of any example herein, particularly example 196, wherein the outer polymer layer is a PEBAX heat shrink layer. [0883] Example 198. A delivery apparatus for a prosthetic device, comprising a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; and a third shaft having a radially expandable first end portion coupled around the distal end of the first shaft, a radially expandable second end portion coupled around a proximal end of the inflatable balloon, and a body extending between the first and second end portions, wherein the body comprises a plurality of openings or cuts along its length that allows it to bend, and wherein the third shaft is configured to transfer torque from the first shaft to the inflatable balloon when the first shaft is rotated. [0884] Example 199. The delivery apparatus of any example herein, particularly example 198, wherein the plurality of openings or cuts extend in a radial direction through at least a portion of a thickness of the third shaft, the thickness defined between a radially outward facing surface and a radially inward facing surface of the third shaft. [0885] Example 200. The delivery apparatus of any example herein, particularly either example 198 or example 199, wherein the plurality of openings or cuts forms a plurality of circumferentially extending rows of openings or cuts that are spaced axially apart from one another. [0886] Example 201. The delivery apparatus of any example herein, particularly example 200, wherein each row of openings or cuts comprises a plurality of individual openings or cuts that are circumferentially spaced apart from one another. [0887] Example 202. The delivery apparatus of any example herein, particularly any one of examples 198-201, wherein at least a portion of openings or cuts of the plurality of opening or cuts each have an elongated diamond shape with a major axis of the elongated diamond shaped cut extending in the circumferential direction. [0888] Example 203. The delivery apparatus of any example herein, particularly any one of examples 198-202, further comprising a crimp balloon extending along the third shaft, and wherein the second shaft extends through the inside of the crimp balloon. [0889] Example 204. The delivery apparatus of any example herein, particularly example 203, wherein the third shaft is arranged inside the crimp balloon. [0890] Example 205. The delivery apparatus of any example herein, particularly either example 203 or example 204, wherein a distal end portion of the crimp balloon is bonded to the inflatable balloon and the second end portion of the third shaft. [0891] Example 206. The delivery apparatus of any example herein, particularly any one of examples 203-205, wherein a proximal end portion of the crimp balloon is bonded to the distal end of the first shaft. [0892] Example 207. The delivery apparatus of any example herein, particularly any one of examples 198-206, wherein the first end portion comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end portion, wherein the lattice structure is radially expandable such that it flares radially outward from the body of the third shaft to a free end of the lattice structure that is coupled around the distal end of the first shaft. [0893] Example 208. The delivery apparatus of any example herein, particularly any one of examples 198-207, wherein the second end portion comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end portion, wherein the lattice structure is radially expandable such that it flares radially outward from the body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon. [0894] Example 209. The delivery apparatus of any example herein, particularly example 6, wherein the second end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end, wherein the lattice structure is radially expandable such that flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon. [0895] Example 210. The delivery apparatus of any example herein, particularly any one of examples 1-15, wherein the first end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end, wherein the lattice structure is radially expandable such that it flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled to the distal end of the first shaft. [0896] Example 211. The delivery apparatus of any example herein, particularly example 18, wherein each row of cuts comprises a plurality of individual cuts that are spaced circumferentially apart around the third shaft, and wherein each individual cut is an elongated diamond shaped cut with a major axis of the diamond shaped cut extending in the circumferential direction. [0897] Example 212. The delivery apparatus of any example herein, particularly example 108, wherein the second end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end, wherein the lattice structure is radially expandable such that flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon. [0898] Example 213. The delivery apparatus of any example herein, particularly any one of examples 89-98, wherein the first end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end, wherein the lattice structure is radially expandable such that it flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled to the distal end of the first shaft. [0899] Example 214. A method comprising sterilizing the prosthetic heart valve, apparatus, and/or assembly of any example. [0900] The features described herein with regard to any example can be combined with other features described in any one or more of the other examples, unless otherwise stated. For example, any one or more of the features of one delivery apparatus can be combined with any one or more features of another delivery apparatus. As another example, any one or more features of one crimp balloon shaft can be combined with any one or more features of another crimp balloon shaft. [0901] In view of the many possible ways in which the principles of the disclosure may be applied, it should be recognized that the illustrated configurations depict examples of the disclosed technology and should not be taken as limiting the scope of the disclosure nor the claims. Rather, the scope of the claimed subject matter is defined by the following claims and their equivalents.

Claims

We claim: 1. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; an inflatable balloon arranged around the distal end portion of the second shaft; a crimp balloon extending from the first shaft to the inflatable balloon, the crimp balloon disposed around the second shaft; and a third shaft extending along the crimp balloon and having a first end coupled to the distal end of the first shaft, wherein a proximal end of the inflatable balloon is coupled to the third shaft, wherein the second shaft extends through the third shaft, and wherein the third shaft is configured to bend relative to a central longitudinal axis of the delivery apparatus.
2. The delivery apparatus of claim 1, wherein the third shaft comprises metal.
3. The delivery apparatus of either claim 1 or claim 2, wherein the third shaft is laser cut to form a repeating pattern of cuts in the metal, along a majority of a length of the third shaft.
4. The delivery apparatus of claim 3, wherein the repeating pattern of cuts includes a plurality of circumferentially extending rows of cuts that are spaced axially apart along the third shaft, wherein each row comprises a plurality of circumferential cuts spaced circumferentially apart around the third shaft.
5. The delivery apparatus of any one of claims 1-4, wherein a second end of the third shaft is coupled to the proximal end of the inflatable balloon, wherein the second end is opposite the first end of the third shaft.
6. The delivery apparatus of claim 5, wherein the second end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the second end, wherein the lattice structure is radially expandable such that flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled around the proximal end of the inflatable balloon.
7. The delivery apparatus of any one of claims 1-6, wherein the first end of the third shaft comprises a lattice structure comprising a plurality of circumferentially extending rows of cells arranged end-to-end around the first end, wherein the lattice structure is radially expandable such that it flares radially outward from a body of the third shaft to a free end of the lattice structure that is coupled to the distal end of the first shaft.
8. The delivery apparatus of either claim 1 or claim 2, wherein the third shift is a braided layer that extends from within the first shaft.
9. An assembly comprising the delivery apparatus of any one of claims 1-8, and further comprising a prosthetic valve mounted in a radially collapsed configuration around the third shaft.
10. The assembly of claim 9, wherein the delivery apparatus further comprises a fourth shaft that surrounds and extends along the first shaft, wherein the fourth shaft and the first shaft are axially movable relative to one another such that the radially collapsed prosthetic valve is movable from the third shaft to a position around the inflatable balloon, and wherein the delivery apparatus is configured to inflate the inflatable balloon and radially expand the prosthetic valve.
11. A delivery apparatus for a prosthetic device, comprising: a rotatable first shaft; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, wherein the inflatable balloon comprises an inflatable body and a proximal leg extending proximally from the inflatable body toward the distal end of the first shaft, wherein the proximal leg has a stiffness specified such that it can transfer torque along its length and bend.
12. The delivery apparatus of claim 11, wherein the proximal leg extends to the distal end of the first shaft.
13. The delivery apparatus of either claim 11 or claim 12, wherein the stiffness of the proximal leg is greater than a stiffness of the inflatable body.
14. The delivery apparatus of any one of claims 11-13, wherein the proximal leg comprises a plurality of longitudinal pleats.
15. A delivery apparatus for a prosthetic device, comprising: a handle; a rotatable first shaft extending distally from the handle, wherein the first shaft is a metal tube comprising a plurality of cuts spaced axially and circumferentially apart along at least a portion of a total length of the first shaft, wherein the plurality of cuts is configured such that the first shaft is bendable; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end of the first shaft; and an inflatable balloon arranged around the distal end portion of the second shaft, and wherein a proximal end portion of the inflatable balloon is bonded to a distal end portion of the first shaft.
16. The delivery apparatus of claim 15, wherein each cut of the plurality of cuts extends through a wall of the metal tube.
17. The delivery apparatus of either claim 15 or claim 16, wherein the plurality of cuts in the first shaft forms a plurality of circumferentially extending rows of cuts that are spaced axially apart from one another.
18. The delivery apparatus of any one of claims 15-17, wherein the plurality of cuts extends along a majority of the total length of the first shaft.
19. The delivery apparatus of any one of claims 15-18, wherein the distal end portion of the first shaft comprises a plurality of apertures extending radially through a wall of the metal tube, and wherein the plurality of apertures is configured to receive a reflowed polymer for bonding the first shaft to the inflatable balloon.
20. The delivery apparatus of any one of claims 15-19, wherein the first shaft comprises an outer polymer layer bonded to an outer surface of the metal tube.
PCT/US2025/021393 2024-03-27 2025-03-25 Delivery apparatus for a prosthetic valve Pending WO2025207668A1 (en)

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US202463570698P 2024-03-27 2024-03-27
US63/570,698 2024-03-27
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US63/651,279 2024-05-23
US202463688649P 2024-08-29 2024-08-29
US63/688,649 2024-08-29

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