Collapsible-expandable prosthetic heart valves with structures for clamping native tissue
A prosthetic heart valve is designed to be circumferentially collapsible for less invasive delivery into the patient. At the implant site the valve re-expands to a larger circumferential size, i.e., the size that it has for operation as a replacement for one of the patient's native heart valves. The valve includes structures that, at the implant site, extend radially outwardly to engage tissue structures above and below the native heart valve annulus. These radially outwardly extending structures clamp the native tissue between them and thereby help to anchor the prosthetic valve at the desired location in the patient.
1. A prosthetic heart valve, comprising:
a stent having an inflow end, an outflow end, an expanded condition and a collapsed condition, the stent including an annularly continuous annulus portion adjacent the inflow end and a plurality of commissure posts each having a connected end connected to the annulus portion and a free end, the annulus portion including a plurality of closed perimeter diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex and the downstream apex portion having a downstream apex, the stent being devoid of structure between adjacent ones of the commissure posts from the connected ends to the free ends, the upstream apex portion of each cell in a group of the cells being resiliently biased to deflect radially outwardly from the connection points and the downstream apex portion of each cell in the group of the cells being resiliently biased to deflect radially outwardly from the connection points;
an expandable and collapsible valve element mounted within the stent; and
a skirt connected to the annulus portion of the stent.
2. The prosthetic heart valve as claimed in claim 1 , wherein the skirt extends annularly around the annulus portion and has a first annular edge positioned downstream from the upstream apices and a second annular edge positioned upstream from the downstream apices.
3. The prosthetic heart valve as claimed in claim 2 , wherein each upstream apex in a group of the upstream apices includes a barb and each downstream apex in a group of the downstream apices includes a barb.
4. The prosthetic heart valve as claimed in claim 2 , further comprising a barb on each of the upstream apices and on each of the downstream apices.
5. The prosthetic heart valve as claimed in claim 1 , wherein the skirt includes a chamber disposed in a circumferential direction around the annulus portion of the stent.
6. The prosthetic heart valve as claimed in claim 5 , wherein the chamber is filled with a polymeric substance.
7. The prosthetic heart valve as claimed in claim 1 , wherein the skirt has an inflow end, an outflow end, and a length in a longitudinal direction of the stent that is less than a length of the annulus portion so that the skirt outflow end is positioned upstream from the downstream apices of the annulus portion.
8. The prosthetic heart valve as claimed in claim 1 , wherein the skirt covers the annulus portion of the stent from the upstream apices to the downstream apices.
9. The prosthetic heart valve as claimed in claim 1 , wherein the skirt includes an inner wall disposed in a circumferential direction around the annulus portion of the stent, and a closed toroidal section disposed in the circumferential direction around the inner wall.
10. The prosthetic heart valve as claimed in claim 9 , wherein the inner wall of the skirt has a first length in the longitudinal direction of the stent and the toroidal section has a second length in the longitudinal direction of the stent, the second length being less than the first length.
11. The prosthetic heart valve as claimed in claim 1 , wherein each of the commissure posts includes an aperture at the free end.
12. A prosthetic heart valve, comprising:
a stent having an inflow end, an outflow end, an expanded condition and a collapsed condition, the stent including an annularly continuous annulus portion adjacent the inflow end, an annularly continuous aortic portion adjacent the outflow end, and a plurality of commissure posts each having a first end connected to the annulus portion and a second end connected to the aortic portion, the annulus portion including a plurality of closed perimeter diamond-shaped cells, each cell having an upstream apex portion directly connected to a downstream apex portion at connection points, the upstream apex portion having an upstream apex and the downstream apex portion having a downstream apex, the stent being devoid of structure between adjacent ones of the commissure posts from the first ends to the second ends, the upstream apex portion of each cell in a group of the cells being resiliently biased to deflect radially outwardly from the connection points and the downstream apex portion of each cell in the group of the cells being resiliently biased to defect radially outwardly from the connection points;
an expandable and collapsible valve element mounted within the stent; and
a skirt connected to the annulus portion of the stent.
13. The prosthetic heart valve as claimed in claim 12 , wherein the skirt extends annularly around the annulus portion and has a first annular edge positioned downstream from the upstream apices and a second annular edge positioned upstream from the downstream apices.
14. The prosthetic heart valve as claimed in claim 13 , further comprising a barb on each of the upstream apices and on each of the downstream apices.
15. The prosthetic heart valve as claimed in claim 12 , wherein the skirt includes an inner wall disposed in a circumferential direction around the annulus portion of the stent, and a closed toroidal section disposed in the circumferential direction around the inner wall.
16. The prosthetic heart valve as claimed in claim 15 , wherein the inner wall of the skirt has a first length in the longitudinal direction of the stent and the toroidal section has a second length in the longitudinal direction of the stent, the second length being less than the first length.
17. The prosthetic heart valve as claimed in claim 15 , wherein the inner wall has a first annular edge positioned downstream from the upstream apices and a second annular edge positioned upstream from the downstream apices.