Prosthetic heart valve for transfemoral delivery

1. Apparatus comprising a valve prosthesis for attachment to a native valve complex of a subject, the valve prosthesis comprising:

a prosthetic heart valve including a plurality of prosthetic leaflets; and

a support frame, which is shaped so as to define:

two or more commissural posts, wherein adjacent prosthetic leaflets of the plurality of prosthetic leaflets of the prosthetic heart valve are attached to each commissural post such that two prosthetic leaflets of the plurality of prosthetic leaflets are attached to each commissural post, wherein the commissural posts are arranged circumferentially around a central longitudinal axis of the valve prosthesis, and wherein each of the commissural posts extends in a downstream direction at a first radially outward angle with respect to the central longitudinal axis,

a bulging upstream skirt disposed upstream of the two or more commissural posts, and

a plurality of axial support extensions, an upstream end of each of the plurality of axial support extensions joined to a downstream side of the upstream skirt and a downstream end of at least some of the plurality of axial support extensions joined to upstream ends of the two or more commissural posts, wherein each axial support extension extends in a downstream direction at a second radially outward angle with respect to the central longitudinal axis, the second radially outward angle being greater than the first radially outward angle, and wherein the axial support extensions are configured to apply an axial force in an upstream direction to leaflets of the native valve complex.

2. The apparatus according to claim 1 , wherein the support frame is shaped so as to define a plurality of upper sinus support elements, which extend in a downstream direction such that downstream ends of the upper sinus support elements are downstream of downstream ends of the two or more commissural posts, the upper sinus support elements being configured to rest against native upper aortic sinuses.

3. The apparatus according to claim 1 , wherein the first radial outward angle is between about 1 and about 15 degrees.

4. The apparatus according to claim 1 , wherein the second radial outward angle is between about 15 and about 45 degrees.

5. The apparatus according to claim 2 , wherein each upper sinus support element joins a respective one of the downstream axial support extensions.

6. The apparatus according to claim 2 , wherein each upper sinus support element joins a respective one of the two or more commissural posts.

7. The apparatus according to claim 2 , wherein each upper sinus support element is bent radially inward toward the central longitudinal axis.

8. The apparatus according to claim 2 , wherein each upper sinus support element comprises a first upstream-most portion and a second upstream-most portion,

wherein the first upstream-most portion of a first upper sinus support element of the plurality of upper sinus support elements joins a first axial support extension of the plurality of axial support extensions,

wherein the second upstream-most portion of the first upper sinus support element joins a first commissural post of the two or more commissural posts,

wherein the first upstream-most portion of a second upper sinus support element of the plurality of upper sinus support elements joins the first axial support extension, and

wherein the second upstream-most portion of a third upper sinus support of the plurality of upper sinus support elements joins the first commissural post.

9. The apparatus according to claim 1 , wherein the bulging upstream skirt comprises a plurality of cells.