Conformable prostheses for implanting two-piece heart valves and methods for using them
A heart valve assembly includes an annular prosthesis and a valve prosthesis. The annular prosthesis includes an annular ring for dilating tissue within a biological annulus and a conformable sewing cuff extending radially from the annular member. The valve prosthesis includes a frame and a valve component. The annular ring is introduced into the biological annulus to dilate tissue surrounding the biological annulus and the sewing cuff conforms to tissue above the biological annulus. Fasteners are directed through the sewing cuff to secure the annular prosthesis to the biological annulus. The annular prosthesis may include a baleen element for biasing fabric on the annular ring outwardly to enhance sealing against the biological annulus. A valve prosthesis is then advanced into the sinus cavity, and secured relative to the annular prosthesis. The sewing cuff may enhance a seal between the valve prosthesis and annular prosthesis.
1. A method for implanting a prosthetic heart valve within a patient, the method comprising the steps of:
(a) implanting within a biological annulus of the patient a sealing member for receiving a valve member having at least one connector, the sealing member having an annular member and a lattice extending adjacent the annular member, the lattice being conformable for adopting a shape of tissue of the biological annulus, the sealing member also having a baleen element positioned around an outer surface of the annular member within a fabric covering; wherein step (a) includes:
arranging the sealing member in a contracted state prior to implanting the sealing member within the biological annulus,
delivering the sealing member to the biological annulus with the sealing member in the contracted state,
transitioning the sealing member from the contracted state to an expanded state following the step of delivering the sealing member to the biological annulus, a diameter defined by the sealing member in the expanded state being greater than the diameter in the contracted state; wherein the baleen element billows the fabric covering outwardly away from the annular member as the sealing member transitions to the expanded state; and
(b) securing the valve member to the implanted sealing member such that at least one connector may interlock with the sealing member.
2. The method of claim 1 , wherein the sealing member is penetrable by fasteners for securing the sealing member to tissue of the biological annulus.
3. The method of claim 1 , wherein the sealing member has a multiple lobular shape corresponding to the shape of the tissue of the biological annulus.
4. The method of claim 1 , wherein the sealing member is resiliently conformable with the shape of the tissue of the biological annulus such that at least one of a circumference and a taper of the sealing member change to accommodate to the shape of the tissue of the biological annulus.
5. The method of claim 1 , wherein the lattice comprises a plurality of ribs at least partially defining openings.
6. The method of claim 1 , wherein the lattice comprises a plurality of ribs extending from at least one of an upper surface and a lower surface of an annular core.
7. The method of claim 1 , wherein the sealing member comprises a plurality of ribs extending from at least one of an upper and lower surface of the sealing member, the ribs being compressible for conforming to a shape of a prosthetic valve secured to the sealing member to enhance sealing between the prosthetic valve and the sealing member.
8. The method of claim 1 , wherein the fabric covering also covers at least a portion of the annular member.
9. The method of claim 1 , the baleen element further comprising a plurality of fingers and further wherein step (a) includes the plurality of fingers billowing the fabric covering outwardly away from the annular ring.
10. The method of claim 9 , wherein the plurality of fingers have varying lengths.
11. The method of claim 1 , wherein the at least one connector comprises a clip secured relative to the sealing member; wherein the clip is captured by the fabric covering.
12. The method of claim 1 , wherein the at least one connector comprises a plurality of magnets on an annular member.
13. The method of claim 1 , wherein securing the valve member to the implanted sealing member further comprises rotating the valve member to interlock at least one connector with the lattice.
14. The method of claim 1 , wherein the lattice includes at least one ear and step (a) further includes aligning the ear with a commissure between a right coronary and a non-coronary sinus cusp.
15. The method of claim 1 , wherein the lattice defines a plurality of enclosed openings that are completely open and free from any material.
16. The method of claim 1 , wherein the lattice defines a plurality of recesses in which a wall of core material is positioned.