Collapsible prosthetic heart valves
Prosthetic heart valves, which are collapsible to a relatively small circumferential size for less invasive delivery into a patient and which then re-expand to operating size at an implant site in the patient, include a collapsible/expandable stent-like supporting structure and various components of flexible, sheet-like material that are attached to the supporting structure. For example, these sheet-like other components may include prosthetic valve leaflets, layers of buffering material, cuff material, etc. Improved structures and techniques are provided for securing such other components to the stent-like supporting structure of the valve.
1. A prosthetic heart valve, comprising:
an annularly collapsible and re-expandable supporting structure extending from an inflow end to an outflow end, the supporting structure including a plurality of cells arranged in annular rows and the inflow end having an inflow edge;
a plurality of leaflets disposed inside the supporting structure and operative to allow flow through the supporting structure in an antegrade direction from the inflow end to the outflow end but to substantially block flow through the supporting structure in a retrograde direction from the outflow end to the inflow end;
an inner cuff disposed on a luminal surface of the supporting structure adjacent the inflow end; and
an outer cuff disposed on an abluminal surface of the supporting structure, the outer cuff including a first end and a second end, the first end being positioned closer to the outflow end than the second end, the second end terminating at the inflow edge of the supporting structure,
wherein the first end of the outer cuff and the second end of the outer cuff are both affixed to the inner cuff, the inner cuff extends a first distance from the inflow edge toward the outflow end of the supporting structure, and the outer cuff extends a second distance from the inflow edge toward the outflow end of the supporting structure, the first distance being greater than the second distance.
2. The prosthetic heart valve as claimed in claim 1 , wherein the inner cuff and the outer cuff are formed of a single piece of material that wraps around the inflow edge of the supporting structure from the luminal surface of the supporting structure to the abluminal surface of the supporting structure.
3. The prosthetic heart valve as claimed in claim 1 , wherein the inner cuff and the outer cuff are formed of separate pieces of material.
4. The prosthetic heart valve as claimed in claim 3 , wherein the second end of the outer cuff is sutured to the inner cuff.
5. The prosthetic heart valve as claimed in claim 1 , wherein the supporting structure includes a plurality of non-cantilevered commissure attachment features.
6. The prosthetic heart valve as claimed in claim 1 , wherein the supporting structure is formed of a self-expanding, super-elastic metal.
7. The prosthetic heart valve as claimed in claim 1 , wherein the supporting structure is formed as a unitary structure from a tube.
8. The prosthetic heart valve as claimed in claim 1 , wherein the inner cuff is disposed on the supporting structure so that there is no contact between the plurality of leaflets and the supporting structure.
9. The prosthetic heart valve as claimed in claim 1 , wherein the inner cuff and the outer cuff collectively cover at least one of the annular rows of cells.
10. The prosthetic heart valve as claimed in claim 1 , wherein the outer cuff is secured to struts of the cells with sutures.
11. The prosthetic heart valve as claimed in claim 10 , wherein the sutures are whip stitch sutures.
12. The prosthetic heart valve as claimed in claim 10 , wherein the sutures outline the struts of the cells.
13. The prosthetic heart valve as claimed in claim 12 , wherein the struts include zig-zag members.
14. The prosthetic heart valve as claimed in claim 1 , wherein the inner cuff and the outer cuff collectively include at least one opening at a periphery of the supporting structure.
15. The prosthetic heart valve as claimed in claim 14 , wherein at least one strut of the supporting structure passes through the at least one opening.
16. The prosthetic heart valve as claimed in claim 1 , wherein the first end of the outer cuff is affixed to the supporting structure.
17. The prosthetic heart valve as claimed in claim 1 , further comprising a reinforcing core coupled to at least one of the plurality of leaflets.
18. The prosthetic heart valve as claimed in claim 17 , wherein the at least one leaflet is disposed between the reinforcing core and the inner cuff.
19. The prosthetic heart valve as claimed in claim 1 , wherein the supporting structure includes a plurality of posts, each post having an elongated opening.
20. The prosthetic heart valve as claimed in claim 19 , further comprising a plurality of patches, each of the patches covering one of the elongated openings and being coupled to flaps of adjacent ones of the plurality of leaflets via sutures.