Reinforcement device for a biological valve and reinforced biological valve
A reinforcement device for a biological valve includes an arrangement of supports configured to establish a double-trigone geometry in the valve and coupled to a base upon which the valve may be mounted. A plurality of commissural supports establish the geometry of a commissural trigone, and a plurality of intercommissural supports establish the geometry of an intercommissural trigone. A method for reinforcing a biological valve includes using commissural supports in conjunction with intercommissural supports, both sets of supports coupled to a base upon which the valve is mounted.
1. A reinforcement device comprising:
a plurality of commissural supports, each commissural support being configured to stabilize a valve wall of a biological valve at a commissure of the biological valve, the biological valve having an inflow region and an outflow region;
a plurality of intercommissural supports, each intercommissural support being configured to stabilize the valve wall at a location circumferentially between two of the commissures; and
a base disposed at the inflow region of the biological valve, the base being attached to the plurality of commissural supports and the plurality of intercommissural supports, the base further being configured to receive the biological valve mounted thereon, wherein the commissural supports and intercommissural supports are discontinuous around the valve wall in the outflow region of the biological valve.
2. The reinforcement device of claim 1 , wherein the commissural supports are configured to stand substantially within the valve wall.
3. The reinforcement device of claim 2 , wherein the intercommissural supports are configured to stand substantially within the valve wall.
4. The reinforcement device of claim 1 , wherein the commissural supports are configured to stand outside the valve wall.
5. The reinforcement device of claim 4 , wherein the commissural supports are configured to be sutured to a valve wall.
6. The reinforcement device of claim 1 , wherein the base is continuous around the valve wall in the inflow region of the biological valve.
7. The reinforcement device of claim 1 , wherein the commissural supports and intercommissural supports are disposed at discrete locations of the valve wall in the outflow region of the biological valve.
8. The reinforcement device of claim 1 , wherein the commissural supports and the intercommissural supports comprise metal wire.
9. The reinforcement device of claim 8 , wherein the metal wire comprises titanium.
10. The reinforcement device of claim 1 , wherein each of the commissural supports comprises first and second straight portions.
11. The reinforcement device of claim 10 , wherein the first and second straight portions are spaced apart by a distance sufficient to avoid damaging a marking zone near the commissure when the commissural support is affixed to the valve wall.
12. The reinforcement device of claim 11 , wherein the first and second straight portions are substantially parallel.
13. The reinforcement device of claim 12 , wherein the first and second straight portions are joined together by a curved portion.
14. The reinforcement device of claim 13 , wherein the curved portion has a constant radius of curvature equal to half the distance between the first and second straight portions.
15. The reinforcement device of claim 10 , wherein the first and second straight portions are configured to stand within the wall of the biological valve.
16. The reinforcement device of claim 13 , wherein the curved portion is configured to stand at least partially outside the wall of the biological valve.
17. The reinforcement device of claim 1 , wherein each of the intercommissural supports comprises substantially parallel first and second straight portions.
18. The reinforcement device of claim 16 , wherein the first and second straight portions are joined together by a curved portion.
19. The reinforcement device of claim 1 , wherein the plurality of commissural supports includes three commissural supports disposed generally symmetrically about the base.
20. The reinforcement device of claim 1 , wherein the plurality of commissural supports includes three commissural supports disposed asymmetrically about the base.
21. The reinforcement device of claim 20 , wherein the plurality of intercommissural supports includes three intercommissural supports, each one of the intercommissural supports being disposed between each pair of commissural supports.
22. The reinforcement device of claim 21 , wherein each of the intercommissural supports is disposed approximately midway between each pair of commissural supports.
23. The reinforcement device of claim 1 , wherein the base comprises a ring and a cover.
24. The reinforcement device of claim 23 , wherein the ring has a thickness substantially equivalent to a thickness of the valve wall.
25. The reinforcement device of claim 23 , wherein the ring has a thickness greater than a thickness of the valve wall.
26. The reinforcement device of claim 1 , wherein the base includes a first plurality of holes configured to closely receive the commissural supports and a second plurality of holes configured to closely receive the intercommissural supports.
27. The reinforcement device of claim 26 , wherein the first plurality comprises five holes for each commissural support for adjustable placement of the commissural supports with respect to the base.
28. A reinforcement device comprising:
a plurality of commissural supports, each commissural support being configured to stabilize a valve wall of a biological valve at a commissure of the biological valve, the biological valve having an inflow region and an outflow region;
a plurality of intercommissural supports, each intercommissural support being configured to stabilize the valve wall at a location circumferentially between two of the commissures;
a base disposed at the inflow region of the biological valve, the base being attached to the plurality of commissural supports and the plurality of intercommissural supports, the base further being configured to receive the biological valve mounted thereon, wherein the base includes a first plurality of holes configured to closely receive the commissural supports and a second plurality of holes configured to closely receive the intercommissural supports; and
a crimping wall configured to secure the commissural supports and intercommissural supports to the base when the crimping wall is pressed against the supports.
29. The reinforcement device of claim 1 , wherein the base comprises metal.
30. The reinforcement device of claim 29 , wherein the metal comprises titanium.
31. The reinforcement device of claim 1 , wherein the biological valve is an aortic valve.
32. The reinforcement device of claim 1 , wherein the biological valve is a mitral valve.
33. A reinforced prosthetic valve comprising:
a biological valve having leaflets attached to an external wall at commissures, the biological valve having an inflow region and an outflow region, the biological valve being mounted on a base;
a plurality of commissural supports extending from the base, each commissural support configured to stabilize the external wall at one of the commissures; and
a plurality of intercommissural supports extending from the base, each intercommissural support being configured to stabilize the external wall at a location circumferentially between two of the commissures, wherein the commissural supports and intercommissural supports do not continuously surround the valve in the outflow region.
34. The reinforced prosthetic valve of claim 33 , wherein the commissural supports and the intercommissural supports are disposed substantially within the external wall.
35. The reinforced prosthetic device of claim 33 , wherein the commissural supports and the intercommissural supports are disposed outside the external wall.
36. The reinforced prosthetic device of claim 35 , wherein the commissural supports and the intercommissural supports are secured to the external wall with sutures.