Nonstented heart valves with formed in situ support
An implantable prosthetic valve having an in situ formable support structure and methods of deploying such a valve are disclosed. In one arrangement, the valve has a base and at least one flow occluder. A first flexible component which is incapable of retaining the valve at a functional site in the arterial vasculature extends proximally of the base of the valve. A second flexible component which is incapable of retaining the valve at a functional site in the arterial vasculature extends distally of the base of the valve. At least one rigidity component combines with at least one of the first and second flexible components to impart sufficient rigidity to the first or second components to retain the valve at the site.
1. A method of in situ formation of a prosthetic valve support at a site of a native valve, comprising the steps of:
providing a prosthetic valve, attached to a flexible support component which is incapable of retaining the prosthetic valve at a functional site in the arterial vasculature, the support component extending both proximally and distally of the base of the native valve;
positioning the prosthetic valve at the site such that the flexible support component spans the site of the native valve; and
supplementing the flexible support component to increase the rigidity of the support component sufficiently to retain the prosthetic valve at the site.
2. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the supplementing step comprises introducing inflation media into the support component.
3. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the supplementing step comprises introducing an elongate flexible filament into the support component.
4. A method of in situ formation of a prosthetic valve support as in claim 2 , additionally comprising the step of increasing the viscosity of the inflation media following introduction into the support component.
5. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of removing the native valve prior to supplementing the flexible support component.
6. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of debulking the native valve prior to supplementing the flexible support component.
7. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of performing a balloon valvuloplasty on the native valve prior to supplementing the flexible support component.
8. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the step of positioning the valve at the site comprises translumenally advancing the prosthetic valve over an aortic arch.
9. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the step of positioning the valve comprises using a trans apical approach.
10. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the step of positioning the valve comprises using a transeptal approach.
11. A method of in situ formation of a prosthetic valve support as in claim 1 , further comprising manipulating the position of the prosthetic valve before the step of supplementing the flexible support component.
12. A method of in situ formation of a prosthetic valve support as in claim 11 , wherein the step of manipulating the position of the prosthetic valve comprises using three control wires.
13. A method of in situ formation of a prosthetic valve support as in claim 12 , additionally comprising the step of permitting perfusion through the prosthetic valve during the manipulating the position step.
14. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of permitting perfusion through the prosthetic valve during the step of supplementing the flexible support component.
15. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of placing a temporary valve downstream from the native valve.
16. A method of in situ formation of a prosthetic valve support as in claim 1 , additionally comprising the step of placing an embolic filter downstream from the native valve.
17. A method of in situ formation of a prosthetic valve support as in claim 1 , wherein the prosthetic valve is functional prior to the step of supplementing the flexible support component to increase the rigidity of the support component sufficiently to retain the valve at the site.
18. A method of in situ formation of a prosthetic valve support at a site of a native valve, comprising the steps of:
providing a prosthetic valve, attached to a flexible support component which is incapable of retaining the valve at a functional site in the arterial vasculature, the support component extending both proximally and distally of the base of the native valve;
positioning the valve at the site such that the flexible support component spans the native valve; and
supplementing the flexible support component to increase the rigidity of the support component sufficiently to retain the valve at the site, wherein the supplementing step comprises introducing inflation media into the support component, and
increasing the viscosity of the inflation media following introduction into the support component.
19. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of removing the native valve prior to supplementing the flexible support component.
20. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of debulking the native valve prior to supplementing the flexible support component.
21. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of performing a balloon valvuloplasty on the native valve prior to supplementing the flexible support component.
22. A method of in situ formation of a prosthetic valve support as in claim 18 , wherein the step of positioning the valve at the site comprises translumenally advancing the prosthetic valve over an aortic arch.
23. A method of in situ formation of a prosthetic valve support as in claim 18 , wherein the step of positioning the valve comprises using a trans apical approach.
24. A method of in situ formation of a prosthetic valve support as in claim 18 , wherein the step of positioning the valve comprises using a transeptal approach.
25. A method of in situ formation of a prosthetic valve support as in claim 18 , further comprising manipulating the position of the prosthetic valve before the step of supplementing the flexible support component.
26. A method of in situ formation of a prosthetic valve support as in claim 25 , wherein the step of manipulating the position of the prosthetic valve comprises using three control wires.
27. A method of in situ formation of a prosthetic valve support as in claim 26 , additionally comprising the step of permitting perfusion through the prosthetic valve during the manipulating the position step.
28. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of permitting perfusion through the prosthetic valve during the step of supplementing the flexible support component.
29. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of placing a temporary valve downstream from the native valve.
30. A method of in situ formation of a prosthetic valve support as in claim 18 , additionally comprising the step of placing an embolic filter downstream from the native valve.
31. A method of in situ formation of a prosthetic valve support as in claim 18 , wherein the prosthetic valve is functional prior to the step of supplementing the flexible support component to increase the rigidity of the support component sufficiently to retain the valve at the site.