Device for the implantation and fixation of prosthetic valves
View Patent ↗A device for the transvascular implantation and fixation of prosthetic heart valves having a self-expanding heart valve stent ( 10 ) with a prosthetic heart valve ( 11 ) at its proximal end is introducible into a patient's main artery. With the objective of optimizing such a device to the extent that the prosthetic heart valve ( 11 ) can be implanted into a patient in a minimally-invasive procedure, to ensure optimal positioning accuracy of the prosthesis ( 11 ) in the patient's ventricle, the device includes a self-expanding positioning stent ( 20 ) introducible into an aortic valve positioned within a patient. The positioning stunt is configured separately from the heart valve stent ( 10 ) so that the two stents respectively interact in their expanded states such that the heart valve stent ( 10 ) is held by the positioning stent ( 20 ) in a position in the patient's aorta relative the heart valve predefinable by the positioning stent ( 20 ).
1. A method of treating a native aortic valve, the method comprising:
positioning an expandable first stent adjacent the native aortic valve, a proximal-most end of the first stent including a plurality of struts, wherein a proximal end of the first stent is closer to a native heart than a distal end of the first stent;
expanding the plurality of struts of the first stent;
after expanding the plurality of struts, positioning the plurality of struts between a wall of an aorta and portions of the native aortic valve, wherein the plurality of struts align the first stent with the native aortic valve in an axial direction;
positioning an expandable second stent radially inward of the portions of the native aortic valve and of the first stent, wherein the second stent includes a prosthetic heart valve; and
expanding the second stent to press the portions of the native aortic valve radially outward toward the first stent, such that the portions of the native aortic valve are positioned between the first stent and the second stent.
2. The method of claim 1 , further comprising introducing the first stent into the aorta via an artery.
3. The method of claim 2 , wherein the first stent is introduced into the aorta via a catheter.
4. The method of claim 3 , wherein the first stent includes a plurality of attachment elements on the distal end of the first stent for attachment to the catheter prior to release.
5. The method of claim 1 , wherein positioning the second stent includes rotating the second stent.
6. The method of claim 1 , further comprising introducing the second stent into the aorta via an artery.
7. The method of claim 1 , wherein the prosthetic heart valve is coupled to a proximal end of the second stent, wherein the proximal end of the second stent is closer to the native heart than a distal end of the second stent.
8. The method of claim 1 , wherein the first stent is connected to the second stent after the second stent is expanded.
9. The method of claim 8 , wherein the first stent includes a plurality of first elements complementary to a plurality of second elements of the second stent, such that the first elements engage the second elements to connect the first stent to the second stent.
10. The method of claim 1 , wherein the struts are curved arcuately in a proximal direction towards the native heart.
11. The method of claim 1 , wherein the struts are curved convexly in a proximal direction towards the native heart.
12. The method of claim 1 , wherein each strut is V-shaped with an apex of the strut pointing in a proximal direction towards the native heart.
13. The method of claim 1 , wherein the second stent is expanded in two or more successive steps.
14. The method of claim 1 , further comprising monitoring a location of at least one of the first stent and the second stent.
15. The method of claim 1 , wherein the second stent is expanded via a balloon catheter.
16. The method of claim 1 , wherein the first stent is self-expandable.
17. The method of claim 1 , wherein the first stent includes Nitinol.
18. A method of treating a native aortic valve, the method comprising:
introducing an expandable first stent in a collapsed configuration into an aorta, a proximal-most end of the first stent including a plurality of struts, wherein a proximal end of the first stent is closer to a native heart than a distal end of the first stent;
positioning the plurality of struts into pockets of the native aortic valve defined by a wall of an aorta and portions of the native aortic valve, wherein the plurality of struts align the first stent with the native aortic valve in an axial direction and a radial direction;
positioning an expandable second stent radially inward of the portions of the native aortic valve and of the first stent, wherein the second stent includes a prosthetic heart valve; and
pressing the portions of the native aortic valve radially outward toward the first stent.
19. The method of claim 18 , wherein the first stent is self-expandable.
20. The method of claim 18 , wherein the portions of the native aortic valve are pressed radially outward with a balloon.
21. The method of claim 18 , wherein the first stent is connected to the second stent after the second stent is expanded.
22. A method of treating a native aortic valve, the method comprising:
positioning an expandable first stent adjacent the native aortic valve, a proximal-most end of the first stent including a plurality of struts, wherein a proximal end of the first stent is closer to a native heart than a distal end of the first stent;
manipulating a catheter to uncover the first stent to allow the first stent to expand;
positioning the plurality of struts into pockets of the native aortic valve defined by a wall of an aorta and portions of the native aortic valve, wherein the plurality of struts align the first stent with the native aortic valve in an axial direction;
positioning an expandable second stent radially inward of the portions of the native aortic valve and of the first stent, wherein the second stent includes a prosthetic heart valve; and
manipulating a catheter to expand the second stent, wherein expansion of the second stent presses the portions of the native aortic valve radially outward toward the first stent, such that the portions of the native aortic valve are clamped between the first stent and the second stent.
23. The method of claim 22 , wherein at least one of the first stent and the second stent is introduced into the aorta via a femoral artery.
24. The method of claim 22 , wherein the first stent is connected to the second stent after the second stent is expanded.
25. A method of treating a native aortic valve, the method comprising:
introducing a self-expandable first stent into an aorta, wherein a proximal-most end of the first stent includes a plurality of struts, and a distal-most end of the first stent includes a plurality of attachment elements coupled to a first catheter, wherein a proximal end of the first stent is closer to a native heart than a distal end of the first stent;
manipulating the first catheter to uncover the first stent to allow the struts to expand;
after expanding the struts, positioning the struts into pockets of the native aortic valve defined by a wall of the aorta and portions of the native aortic valve, wherein the struts align the first stent with the native aortic valve in an axial direction;
after positioning the struts in the pockets of the native aortic valve, positioning an expandable second stent radially inward of the portions of the native aortic valve and of the first stent, wherein the second stent includes a prosthetic heart valve; and
manipulating a second catheter to expand the second stent, wherein expansion of the second stent presses the portions of the native aortic valve radially outward toward the first stent, such that the portions of the native aortic valve are clamped between the first stent and the second stent.
26. The method of claim 25 , wherein the first stent is introduced into the aorta via a femoral artery.
27. The method of claim 25 , wherein the second stent is introduced into the aorta via a femoral artery before positioning the second stent radially inward of the first stent and of the portions of the native aortic valve.
28. The method of claim 25 , wherein the first stent includes three attachment elements.
29. The method of claim 25 , wherein the first stent is connected to the second stent after the second stent is expanded.
30. The method of claim 25 , wherein each strut is V-shaped with an apex of the strut pointing in a proximal direction towards the native heart.