Prosthetic heart valve implant
A prosthetic heart valve implant is provided including a frame shaped so as to define upstream and downstream openings at upstream and downstream ends of the frame, respectively, when the implant is in an expanded state for implantation at a heart native valve. A sheet is coupled to the frame. When the implant is in the expanded state, the frame is shaped so as to define the following longitudinal portions arranged along a central longitudinal axis of the prosthetic heart valve implant: a substantially cylindrical mid portion having a diameter greater than respective diameters of the upstream and the downstream ends of the frame; an upstream portion, extending upstream and radially inward from the mid portion; and a downstream portion, extending downstream and radially inward from the mid portion. Other embodiments are also described.
1. A prosthetic heart valve implant for use at a native valve of a heart of a subject, the implant configured to assume a compressed delivery state for percutaneous delivery to the heart and an expanded state for implantation at the native valve, the implant comprising:
a frame, which is shaped so as to define interconnected cells that define upstream and downstream ends of the frame and upstream and downstream openings at the upstream and the downstream ends, respectively, when the implant is in the expanded state;
a sheet, which is coupled to the frame; and
a plurality of prosthetic leaflets, configured to facilitate downstream movement of blood and to inhibit upstream movement of blood when the implant is implanted at the native valve,
wherein when the implant is in the expanded state, the frame is shaped so as to define the following longitudinal portions arranged along a central longitudinal axis of the prosthetic heart valve implant:
a mid portion that is entirely substantially cylindrical and has a diameter greater than respective diameters of the upstream and the downstream ends of the frame,
an upstream portion, extending upstream and curving radially inward from the mid portion, and
a downstream portion, extending downstream and curving radially inward from the mid portion, and
wherein a diameter of the mid portion is greater than a height of the frame between the upstream and the downstream ends of the frame.
2. The prosthetic heart valve implant according to claim 1 , wherein the upstream portion of the frame is shaped so as to define a frustoconical portion and a curved portion longitudinally between the frustoconical portion and the mid portion when the implant is in the expanded state.
3. The prosthetic heart valve implant according to claim 2 , wherein the frustoconical portion extends to the upstream end of the frame when the implant is in the expanded state.
4. The prosthetic heart valve implant according to claim 1 , wherein the downstream portion of the frame is shaped so as to define a frustoconical portion and a curved portion longitudinally between the frustoconical portion and the mid portion when the implant is in the expanded state.
5. The prosthetic heart valve implant according to claim 4 , wherein the frustoconical portion extends to the downstream end of the frame when the implant is in the expanded state.
6. The prosthetic heart valve implant according to claim 1 , wherein when the implant is in the expanded state:
the upstream portion of the frame is shaped so as to define a first frustoconical portion and a first curved portion longitudinally between the first frustoconical portion and the mid portion, and
the downstream portion of the frame is shaped so as to define a second frustoconical portion and a second curved portion longitudinally between the second frustoconical portion and the mid portion.
7. The prosthetic heart valve implant according to claim 6 , wherein the first and the second frustoconical portions extend to the upstream and the downstream ends of the frame, respectively when the implant is in the expanded state.
8. The prosthetic heart valve implant according to claim 1 , wherein a diameter of the upstream end of the frame is less than a diameter of the downstream end of the frame when the implant is in the expanded state.
9. The prosthetic heart valve implant according to claim 1 ,
wherein the frame is a first frame, wherein the upstream end is a first upstream end of the first frame, and wherein the downstream end is a first downstream end of the first frame, and
wherein the prosthetic heart valve implant further comprises a second frame, which is distinct from the first frame and coupled to the sheet.
10. The prosthetic heart valve implant according to claim 9 , wherein the sheet is shaped so as to define an upstream frustoconical portion that couples the upstream portion of the first frame to the second frame.
11. The prosthetic heart valve implant according to claim 9 , wherein a greatest diameter of the second frame is less than a greatest diameter of the first frame when the implant is in the expanded state.
12. The prosthetic heart valve implant according to claim 9 , wherein a second upstream end of the second frame is located downstream of the first upstream end of the first frame when the implant is in the expanded state.
13. The prosthetic heart valve implant according to claim 9 , wherein the first and the second frames axially overlap each other when the implant is in the expanded state.
14. The prosthetic heart valve implant according to claim 9 , further comprising a plurality of snares, which, when the implant is in the expanded state, protrude radially outward and upstream from the second frame, alongside the prosthetic heart valve implant.
15. The prosthetic heart valve implant according to claim 14 , wherein the snares are configured to contact and apply an upstream force to leaflets of the native valve when the implant is implanted at the native valve.
16. The prosthetic heart valve implant according to claim 14 , wherein the snares protrude radially outward from a downstream portion of the second frame when the implant is in the expanded state.
17. The prosthetic heart valve implant according to claim 16 , wherein respective tips of the snares point downstream when the implant is in the compressed delivery state.
18. The prosthetic heart valve implant according to claim 16 , wherein the snares, when the implant is in the expanded state, extend downstream from the second frame to respective curved downstream-most portions of the snares, and protrude radially outward and upstream from the respective curved downstream-most portions, alongside the prosthetic heart valve implant.
19. The prosthetic heart valve implant according to claim 1 , further comprising a plurality of snares, which, when the implant is in the expanded state, protrude radially outward and upstream alongside the prosthetic heart valve implant.
20. The prosthetic heart valve implant according to claim 19 , wherein the snares are configured to contact and apply an upstream force to leaflets of the native valve when the implant is implanted at the native valve.
21. The prosthetic heart valve implant according to claim 19 , wherein the snares protrude radially outward from a downstream portion of the prosthetic heart valve when the implant is in the expanded state.
22. The prosthetic heart valve implant according to claim 21 , wherein respective tips of the snares point downstream when the implant is in the compressed delivery state.
23. The prosthetic heart valve implant according to claim 21 , wherein the snares, when the implant is in the expanded state, extend downstream from the downstream portion of the prosthetic heart valve to respective curved downstream-most portions of the snares, and protrude radially outward and upstream from the respective curved downstream-most portions, alongside the prosthetic heart valve implant.
24. The prosthetic heart valve implant according to claim 19 , wherein the snares protrude radially outward and upstream at an angle with the central longitudinal axis of the prosthetic heart valve implant of greater than 10 degrees when the implant is in the expanded state.
25. The prosthetic heart valve implant according to claim 19 , wherein the sheet is not attached to the snares.
26. The prosthetic heart valve implant according to claim 1 , wherein the prosthetic leaflets are attached to the sheet.
27. The prosthetic heart valve implant according to claim 1 , wherein the frame is metallic.
28. The prosthetic heart valve implant according to claim 1 , wherein the downstream portion of the frame is more lined by the sheet than is the upstream portion of the frame.
29. The prosthetic heart valve implant according to claim 1 , wherein a portion of the sheet extends upstream from the downstream end of the frame and terminates before reaching the upstream portion of the frame.