Prosthetic heart valve with paravalvular leak mitigation features
A prosthetic heart valve includes a collapsible stent and a valve assembly disposed within the stent. A first cuff is disposed adjacent the stent. A second cuff having a distal edge facing the outflow end of the stent is disposed about the stent radially outward of the first cuff and the stent. The stent may include a plurality of fingers each having a first end coupled to a corresponding cell of the stent and a free end adapted to extend radially outward of the corresponding cell. The distal edge of the second cuff may be coupled to the fingers at spaced locations around the circumference of the stent to position the distal edge radially outward from the corresponding cells at the spaced locations. Various stent struts may be tapered to reduce the stent circumference in the collapsed condition, and to improve the fatigue resistance and/or bendability of the stent.
1. A prosthetic heart valve for replacing a native valve, comprising:
a stent having an inflow end, an outflow end, a plurality of cells formed by cell struts, a collapsed condition and an expanded condition;
a valve assembly disposed within the stent;
a first cuff annularly disposed adjacent the stent; and
a second cuff having a proximal edge facing toward the inflow end of the stent and a distal edge facing toward the outflow end of the stent, the second cuff being annularly disposed about the stent radially outward of the first cuff and radially outward of the stent, the distal edge including a plurality of peaks and a plurality of troughs, each trough connecting a pair of adjacent peaks, a distalmost portion of each peak being directly coupled to at least one of the first cuff and the stent.
2. The prosthetic heart valve of claim 1 , wherein the distalmost portion of each peak is coupled to at least one of the first cuff and the stent by a suture.
3. The prosthetic heart valve of claim 1 , wherein the plurality of peaks and the plurality of troughs each have a curved edge.
4. The prosthetic heart valve of claim 1 , wherein the plurality of peaks and the plurality of troughs each have a straight edge.
5. The prosthetic heart valve of claim 1 wherein each peak includes a base at a proximalmost portion of the peak, the base having a first width in a circumferential direction of the stent, the distalmost portions of two adjacent peaks being spaced apart a second width in the circumferential direction of the stent, the second width being greater than the first width.
6. The prosthetic heart valve of claim 5 , wherein the base of each peak and the distalmost portion of each peak are spaced apart a first height in a longitudinal direction of the stent, the first height being equal to the second width.
7. The prosthetic heart valve of claim 1 , wherein a proximalmost portion of each peak has a first width in a circumferential direction of the stent, and proximalmost portions of two adjacent troughs are spaced apart a second width in the circumferential direction of the stent, the first width being smaller than the second width.
8. The prosthetic heart valve of claim 7 , wherein the first width is between one half and one fifth the second width.
9. The prosthetic heart valve of claim 1 , wherein each peak has a first height in a longitudinal direction of the stent, and each trough has a second height in the longitudinal direction of the stent, the first height being greater than the second height.
10. The prosthetic heart valve of claim 1 , wherein the plurality of cells include a first annular row of cells and a second annular row of cells, the first annular row of cells being positioned closer to the inflow end of the stent than is the second annular row of cells, each cell in the first annular row having a strut in common with a cell in the second annular row.
11. The prosthetic heart valve of claim 10 , wherein the distal edge of the second cuff is aligned with the struts in common when the stent is in the expanded condition.
12. The prosthetic heart valve of claim 10 , wherein each of the struts in common extends a first height in a longitudinal direction of the stent when the stent is in the expanded condition, and the distalmost portion of each peak is spaced apart from a proximalmost portion of each trough a second height in the longitudinal direction of the stent, the second height being greater than the first height.