Structural members for prosthetic mitral valves
A self-expanding wire frame for a pre-configured compressible transcatheter prosthetic cardiovascular valve, a combined inner frame/outer frame support structure for a prosthetic valve, and methods for deploying such a valve for treatment of a patient in need thereof, are disclosed.
1. An apparatus, comprising:
an outer frame formed of expanded shape memory alloy;
an inner frame formed of shape memory alloy and coupled to the outer frame, the inner frame having a first portion expanded from an initial shape and a second portion compressed from an initial shape; and
a prosthetic valve leaflet assembly disposed within the first portion of the inner frame,
the second portion defining a lumen having a width and a length greater than the width, and configured to engage a tether within the lumen,
wherein a distal end of the outer frame is disposed distal to a distal end of the inner frame.
2. The apparatus of claim 1 , further comprising a radiopaque indicator formed on the outer frame.
3. The apparatus of claim 1 , wherein the inner frame is connected to the outer frame by mechanical fasteners.
4. The apparatus of claim 1 , further comprising the tether, the tether having a length sufficient to extend from within the lumen of the second portion of the inner frame through an opening in a wall of a ventricle of an atrioventricular valve of a heart and out the wall when the outer frame is disposed in a native annulus of the atrioventricular valve of the heart.
5. The apparatus of claim 1 , wherein the inner frame is formed from a tube of shape memory alloy having an initial diameter, the first portion of the inner frame expanded from the initial diameter to have a diameter larger than the initial diameter, the second portion of the inner frame compressed from the initial diameter to have a diameter smaller than the initial diameter.
6. The apparatus of claim 1 , further comprising the tether, the second portion of the inner frame being disposed circumferentially continuously about the end portion of the tether when the first portion is engaging the tether within the lumen.
7. The apparatus of claim 1 , wherein the second portion of the inner frame is configured to fixedly retain an end portion of the tether relative to the second portion.
8. The apparatus of claim 1 , further comprising the tether, the inner frame defining a longitudinal centerline axis therethrough, an end portion of the tether being clamped within the lumen of the second portion of the inner frame and along the longitudinal centerline axis.
9. The apparatus of claim 1 , wherein the lumen is defined along a flow axis defined in part by the prosthetic valve leaflet assembly.
10. An apparatus, comprising:
an outer frame formed of expanded shape memory alloy;
an inner frame formed of shape memory alloy and coupled to the outer frame; and
a prosthetic valve leaflet assembly disposed within a first portion of the inner frame,
a second portion of the inner frame defining a lumen configured to receive an end portion of a tether and fixedly retain the end portion relative to the second portion of the inner frame,
wherein a distal end of the outer frame is disposed distal to a distal end of the inner frame.
11. The apparatus of claim 10 , wherein the first portion of the inner frame is expanded from an initial shape and the second portion is compressed from the initial shape, the first portion have a diameter greater than a diameter of the initial shape, the second portion having a diameter less than the initial shape.
12. The apparatus of claim 10 , wherein the second portion of the inner frame is configured to be disposed circumferentially continuously about the end portion of the tether when the end portion of the tether is fixedly retained within the lumen of the second portion.
13. The apparatus of claim 10 , wherein the lumen is defined along a flow axis defined in part by the prosthetic valve leaflet assembly.
14. The apparatus of claim 10 , further comprising the tether, an end portion of the tether extending from within the lumen of the second portion of the inner frame such that an opposite end of the tether can extend and anchor the inner frame to an epicardial surface of a heart when the inner frame is disposed within the heart.
15. The apparatus of claim 10 , wherein the second portion is configured to be secured to the tether at least in part with at least one of a pin or a suture when the tether is engaged within the lumen of the second portion of the inner frame.
16. An apparatus, comprising:
an outer frame formed of expanded shape memory alloy;
an inner frame formed of shape memory alloy and coupled to the outer frame, the inner frame having a first portion expanded from an initial shape and a second portion compressed from an initial shape; and
a prosthetic valve leaflet assembly disposed within the first portion of the inner frame,
the second portion defining longitudinal extensions of struts connected circumferentially by pairs of opposed V-shaped connecting members, a lumen being defined within the connecting members and configured to engage a tether within the lumen, (1) vertices of the V-shaped connecting members configured to move closer together longitudinally and (2) open ends of the V-shaped connecting members configured to move closer together circumferentially, in response to a compressive force applied to the second portion.
17. The apparatus of claim 16 , wherein the inner frame is connected to the outer frame by mechanical fasteners.
18. The apparatus of claim 16 , further comprising the tether, an end portion of the tether extending from within the lumen of the second portion of the inner frame such that an opposite end of the tether can extend and anchor the inner frame to an epicardial surface of a heart when the inner frame is disposed within the heart.
19. The apparatus of claim 16 , wherein the inner frame is formed from a tube of shape memory alloy having an initial diameter, the first portion of the inner frame expanded from the initial diameter to have a diameter larger than the initial diameter, the second portion of the inner frame compressed from the initial diameter to have a diameter smaller than the initial diameter.
20. The apparatus of claim 16 , wherein a distal end of the outer frame is disposed distal to a distal end of the inner frame.
21. The apparatus of claim 16 , wherein the second portion of the inner frame is configured to fixedly retain an end portion of the tether relative to the second portion.