Methods and apparatus for endovascularly replacing a patient's heart valve
The present invention provides methods and apparatus for endovascularly replacing a patient's heart valve. The apparatus includes a replacement valve and an anchor having an expandable braid. In some embodiments, the expandable braid is fabricated from a single strand of wire. In some embodiments, the expandable braid comprises at least one turn feature. The anchor and the valve preferably are configured for endovascular delivery and deployment.
1 . Apparatus for replacing a native aortic valve, the apparatus comprising:
an anchor comprising an expandable braid, the anchor being adapted to be endovascularly delivered and expanded via active foreshortening at an anchor site within the native aortic valve; and
a replacement valve configured to be secured within the anchor.
2 . The apparatus of claim 1 wherein the anchor comprises a central axis, the anchor being further adapted to remain substantially undeformed in response to a pressure up to 0.5 atm directed substantially radially inward toward the central axis.
3 . The apparatus of claim 2 wherein the anchor is further adapted to remain substantially undeformed in response to a pressure up to 2 atm directed substantially radially inward toward the central axis.
4 . The apparatus of claim 1 wherein the braid comprises a first region and a second region having a diameter larger than a diameter of the first region when the anchor is expanded.
5 . The apparatus of claim 4 wherein the braid defines a plurality of cells, at least a first set of the cells in the first region each being of a substantially different configuration than a second set of the cells in the second region.
6 . The apparatus of claim 5 wherein the braid further comprises a third region having a diameter larger than the first region diameter when the anchor is expanded.
7 . The apparatus of claim 6 wherein the braid defines a plurality of cells, at least a first set of the cells in the first region each being of a substantially different configuration than a second set of the cells in the second region and a third set of cells in the third region.
8 . The apparatus of claim 1 wherein the anchor is further adapted to avoid interference with coronary ostia.
9 . The apparatus of claim 1 wherein the anchor is further adapted to avoid interference with a mitral valve.
10 . The apparatus of claim 9 wherein the braid comprises a region adapted to prevent expansion of the anchor into the mitral valve.
11 . The apparatus of claim 1 wherein the braid is configured to have an expanded shape that is radially symmetrical.
12 . The apparatus of claim 1 wherein the braid is configured to have an expanded shape that is bilaterally symmetrical.
13 . The apparatus of claim 1 wherein the delivery length is between about 15 mm and about 150 mm and the deployed length is between 5 mm and about 40 mm.
14 . The apparatus of claim 1 wherein the braid is configured to have an expanded shape that is asymmetrical.
15 . The apparatus of claim 1 wherein the anchor comprises first and second wires, the first wire having a diameter smaller than a diameter of the second wire.
16 . The apparatus of claim 1 wherein the anchor comprises first and second wires formed from different materials.
17 . The apparatus of claim 1 wherein the anchor has a collapsed delivery configuration, an at-rest configuration and an expanded deployed configuration.
18 . The apparatus of claim 17 wherein the braid comprises a shape memory material that is heat set in the at-rest configuration.
19 . The apparatus of claim 17 wherein the at-rest configuration is between the collapsed delivery configuration and expanded deployed configuration.
20 . The apparatus of claim 1 further comprising a lock configured to maintain expansion of the braid.
21 . The apparatus of claim 1 further comprising a plurality of locks configured to maintain expansion of the braid.
22 . The apparatus of claim 1 further comprising a valve support adapted to support the replacement valve within the anchor.
23 . The apparatus of claim 22 further comprising a lock configured to maintain expansion of the braid.
24 . The apparatus of claim 23 wherein the lock comprises an extension of the valve support.
25 . The apparatus of claim 1 wherein the anchor comprises a distal deployment system interface at a distal end of the anchor, the distal deployment system interface being adapted to permit a deployment system to apply a proximally directed force on the distal end of the anchor.
26 . The apparatus of claim 25 wherein the distal deployment system interface is further adapted to expand radially during application of a proximally directed force on the distal end of the anchor.
27 . The apparatus of claim 26 wherein the distal deployment system interface is further adapted to permit a deployment system to apply a proximally directed force on the distal end of the anchor without passing any portion of a deployment system through a center opening of the replacement valve.
28 . The apparatus of claim 1 wherein the anchor comprises a proximal deployment system interface at a proximal end of the anchor, the proximal deployment system interface being adapted to permit a deployment system to apply a distally directed force on the proximal end of the anchor.
29 . The apparatus of claim 28 wherein the proximal deployment system interface is further adapted to expand radially during application of a distally directed force on the proximal end of the anchor.
30 . The apparatus of claim 28 wherein the proximal deployment system interface is further adapted to permit a deployment system to apply a distally directed force on the proximal end of the anchor through a plurality of deployment system fingers.