Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods
Devices and methods for implantation at a native mitral valve having a non-circular annulus and leaflets. One embodiment of the device includes a valve support having a first region configured to be attached to a prosthetic valve with a plurality of prosthetic leaflets and a second region. The device can further include an anchoring member having a longitudinal dimension and including a first portion configured to contact tissue at the non-circular annulus, a second portion configured to be attached to the valve support, and a lateral portion between the first portion and the second portion. The second portion of the anchoring member is attached to the second region of the valve support while in a low-profile configuration in which the anchoring member and the valve support are configured to pass through vasculature of a human. The lateral portion is transverse to the longitudinal dimension. The anchoring member and the valve support are configured to move from the low-profile configuration to an expanded configuration in which the first portion of the anchoring member at least partially adapts to the non-circular annulus of the native mitral valve and the first region of the valve support is spaced inwardly from the first portion of the anchoring member relative to the longitudinal dimension of the anchoring member such that a shape of the first region of the valve support is at least partially independent of a shape of the first portion of the anchoring member.
1. A prosthetic heart valve device for treating a valve of a human heart having a native annulus and native leaflets, comprising:
a valve support having an upstream region and a downstream region with respect to a direction of blood flow;
a prosthetic valve within the upstream region of the valve support; and
an anchoring member having a connection structure and a fixation portion, the connection structure being attached to the downstream region of the valve support and at least a portion of the connection structure extends laterally outward with respect to the valve support in a deployed state, the fixation portion being spaced laterally apart from the valve support by the connection structure in the deployed state, wherein the fixation portion has a plurality of interconnected struts that define an annular engagement surface which extends upstream generally along the blood flow direction at an angle transverse with respect to the connection structure, and wherein the annular engagement surface anchors the device to the native annulus.
2. The device of claim 1 wherein the upstream region of the valve support has an upstream end and the engagement surface has an upstream end, and the upstream end of the valve support and the upstream end of the engagement surface are at approximately the same elevation.
3. The device of claim 1 wherein the valve support comprises an inner annular frame and the fixation portion comprises an outer annular frame spaced radially outward apart from the inner annular frame in the deployed state.
4. The device of claim 3 wherein the outer annular frame is configured to exert a radially outward force against an inner surface of the native annulus that secures the device to the native annulus during ventricular systole without tethers.
5. The device of claim 4 wherein the outer annular frame is configured to deflect inwardly toward the inner annular frame when the engagement surface exerts the radially outward force against the inner surface of the native annulus.
6. The device of claim 3 wherein the inner annular frame and the outer annular frame extend in a longitudinal direction in an unbiased expanded state, and wherein the outer annular frame is deflectable through a range of angles such that the outer annular frame inclines inwardly in an upstream direction from the connection structure toward the inner annular frame in the deployed state.
7. The device of claim 3 wherein the outer annular frame has a downstream end, an upstream end, and a height between the downstream and upstream ends of 10 mm - 20 mm.
8. The device of claim 7 wherein the outer annular frame has a first radial flexibility and the connection structure has a second radial flexibility different than the first flexibility such that the outer annular frame is deflectable with respect to the connection structure through a range of angles in the deployed state.
9. The device of claim 3 wherein, in an unbiased expanded state, the inner annular frame is a first right cylinder and the outer annular frame is a second right cylinder surrounding the first right cylinder.
10. The device of claim 3 wherein the outer annular frame has a plurality of tissue engaging elements projecting outwardly from the engagement surface in an upstream direction.
11. A prosthetic heart valve device for treating a valve of a human heart having a native annulus and native leaflets, comprising:
an inner annular frame with an upstream region and a downstream region relative to a direction of blood flow;
a prosthetic valve within the upstream region of the inner annular frame; and
an anchoring member having a connection structure fixedly attached to the downstream portion of the inner annular frame before deployment of the prosthetic heart valve device and an outer annular frame having interconnected struts that define an outwardly facing engagement surface configured to engage an inwardly facing surface of the native annulus, wherein, in a deployed state, the connection structure extends outward from the inner frame and spaces the outer annular frame radially outward from the inner frame and such that the engagement surface exerts a radially outward force against an inner surface of the native annulus that secures the device to the native annulus.
12. The device of claim 11 wherein the outer annular frame extends upstream from the connection structure to an elevation at least proximate the upstream region of the inner annular frame, and the outer annular frame extends at an angle with respect to the connection structure.
13. The device of claim 12 wherein the outer annular frame extends from the connection structure proximally in a longitudinal direction of the device and is configured to deflect inwardly in an upstream direction toward the inner annular frame when the engagement surface exerts the radially outward force against the inner surface of the native annulus.
14. The device of claim 11 wherein the inner annular frame and the outer annular frame extend in a longitudinal direction in an unbiased expanded state, and wherein the outer annular frame is deflectable through a range of angles such that the outer annular frame inclines in an upstream direction inwardly from the connection structure toward the inner annular frame in the deployed state.
15. The device of claim 11 wherein the outer annular frame has a downstream end, an upstream end, and a height between the downstream and upstream ends of 10 mm - 20 mm.
16. The device of claim 15 wherein the outer annular frame is configured to deflect inwardly in the deployed state.
17. The device of claim 11 wherein, in an unbiased expanded state, the inner annular frame is a first right cylinder and the outer annular frame is a second right cylinder surrounding the first right cylinder.
18. The device of claim 11 wherein the outer annular frame has a plurality of tissue engaging elements projecting outwardly from the engagement surface in an upstream direction.
19. A prosthetic heart valve device for treating a valve of a human heart having a native annulus and native leaflets, comprising:
a valve support having a cylindrical inner frame extending around a longitudinal axis, wherein the valve support has an upstream region and a downstream region, wherein the upstream region includes an upstream end of the valve support;
a prosthetic valve having a plurality of leaflets within the inner frame; and
an anchoring member having an outer frame completely surrounding the upstream region of the inner frame at a position along the longitudinal axis substantially the same as the upstream region of the valve support, the outer frame having an engagement surface that faces laterally outward in an unbiased expanded state, wherein the anchoring member is resiliently biased to a deployed state in which the outer frame is spaced radially apart from the inner frame and is thereby configured to exert a radially outward force against the inner surface of the native annulus that secures the heart valve device against ventricular systole forces without tethers.
20. The device of claim 19 wherein the outer frame comprises a plurality of interconnected struts that extend circumferentially about the outer frame.
21. The device of claim 20 wherein the interconnected struts have a diamond-like configuration.
22. The device of claim 19 wherein the outer frame is configured to be between the native annulus and the inner frame in the deployed state when the engagement surface engages the inner surface of the native annulus.
23. The device of claim 19 , further comprising an atrial retainer coupled to the outer frame, and wherein the atrial retainer extends laterally outward from an upstream end of the outer frame.
24. The device of claim 19 , further comprising a plurality of engagement elements projecting outwardly from the engagement surface.
25. A prosthetic heart valve device for treating a valve of a human heart having a native annulus and native leaflets, comprising:
an inner cylindrical frame with an upstream region and a downstream region relative to a direction of blood flow, wherein the inner cylindrical frame is configured to retain a prosthetic valve in at least the upstream region;
a connection structure fixedly attached to the downstream region of the inner cylindrical frame when the prosthetic heart valve device is in an undeployed state; and
an outer cylindrical frame having interconnected struts that define an outwardly facing engagement surface configured to engage an inwardly facing surface of the native annulus, wherein, in a deployed state, the connection structure spaces the outer cylindrical frame radially outward from the inner cylindrical frame such that the engagement surface is configured to exert a radially outward force against an inner surface of the native annulus that secures the device to the native annulus.
26. The device of claim 25 wherein, in an unbiased expanded state, the inner cylindrical frame has a first diameter and the outer cylindrical frame has a second diameter greater than the first diameter.
27. The device of claim 26 wherein the inner and outer cylindrical frames are first and second right cylinders, respectively.
28. The device of claim 25 wherein the outer frame comprises a plurality of interconnected struts that extend circumferentially about the outer frame.
29. The device of claim 28 wherein the interconnected struts have a diamond-like configuration.
30. The device of claim 25 , further comprising an atrial retainer coupled to the outer frame, and wherein the atrial retainer extends laterally outward from an upstream end of the outer frame.