Repositionable endoluminal support structure and its applications
A prosthetic heart valve includes a frame, a valve component, and an actuation mechanism. The frame has a plurality of struts interconnected by a plurality of joints and is movable between expanded and compressed configurations. The valve component is inside the frame and has a plurality of leaflets. The actuation mechanism has a first expansion element coupled to the frame at a first location and a second expansion element coupled to the frame at a second location. The actuation mechanism is configured such that moving the first expansion element and the second expansion element toward each other in a first direction results in the frame moving from the compressed configuration to the expanded configuration, and such that moving the first expansion element and the second expansion element away from each other in a second direction results in the frame moving from the expanded configuration to the compressed configuration.
1. An assembly comprising:
a prosthetic heart valve comprising:
a frame having first and second end portions, a longitudinal axis extending between the first and second end portions, and a plurality of struts interconnected by a plurality of joints, wherein the frame is movable between an expanded configuration and a compressed configuration;
a valve component inside the frame, the valve component comprising a plurality of leaflets; and
an actuation mechanism comprising a first expansion element and a second expansion element, wherein the first expansion element is coupled to the frame at a first location, wherein the second expansion element is coupled to the frame at a second location axially spaced from the first location, wherein the first location and the second location are radially equidistant from the longitudinal axis, wherein the actuation mechanism is configured such that moving the first expansion element and the second expansion element toward each other in a first direction parallel to the longitudinal axis of the frame results in the frame moving from the compressed configuration to the expanded configuration, and wherein the actuation mechanism is configured such that moving the first expansion element and the second expansion element away from each other in a second direction parallel to the longitudinal axis of the frame results in the frame moving from the expanded configuration to the compressed configuration; and
a delivery apparatus comprising a shaft and an actuation member, wherein the shaft comprises a first end portion and a second end portion, wherein the actuation member extends from the first end portion of the shaft to the second end portion of the shaft, wherein the second end portion of the shaft is configured to contact the second expansion element of the prosthetic heart valve, and wherein the actuation member is releasably coupled to the first expansion element of the prosthetic heart valve and is configured to move the first expansion element of the prosthetic heart valve relative to the second expansion element of the prosthetic heart valve.
2. The assembly of claim 1 , wherein the first expansion element of the prosthetic heart valve comprises a rod, wherein the second expansion element of the prosthetic heart valve comprises an opening through which the first expansion element extends.
3. The assembly of claim 1 , wherein the first expansion element of the prosthetic heart valve is configured to be releasably coupled to the actuation member of the delivery apparatus.
4. The assembly of claim 3 , wherein the actuation member is a pull wire.
5. The assembly of claim 1 , wherein the shaft is a catheter shaft comprising a lumen extending from the first end portion to the second end portion, and wherein the lumen is configured for receiving the actuation member.
6. The assembly of claim 1 , wherein the delivery apparatus is configured for retrograde delivery of the prosthetic heart valve to a native aortic valve.
7. An assembly for implanting a prosthetic heart valve, the assembly comprising:
a prosthetic heart valve comprising:
an annular frame having first and second end portions, a longitudinal axis extending between the first and second end portions, and a plurality of struts pivotably coupled together, wherein the frame is movable between a radially expanded configuration and a radially compressed configuration by pivoting the struts relative to each other;
a valve component coupled to the frame and having a plurality of leaflets, wherein the leaflets are configured to move between an open configuration and a closed configuration, wherein in the open configuration, the leaflets allow blood flow from the first end portion of the frame to the second end portion of the frame, and wherein in the closed configuration, the leaflets restrict blood flow from the second end portion of the frame to the first end portion of the frame;
an expansion mechanism coupled to the frame and comprising a first expansion element and a second expansion element, wherein the first expansion element is coupled to the frame at a first axial location, wherein the second expansion element is coupled to the frame at a second axial location spaced apart from the first axial location, and wherein a line extending from the first axial location to the second axial location is parallel to the longitudinal axis; and
a ratcheting mechanism configured to lock the frame at incremental diameters; and
a delivery apparatus comprising a wire and a catheter shaft, wherein the wire extends through the catheter shaft and is releasably coupled to the first expansion element of the prosthetic heart valve, wherein moving the wire in a first axial direction relative to the catheter shaft causes the first expansion element of the prosthetic heart valve to move in the first axial direction relative to the second expansion element of the prosthetic heart valve, which results in the frame of the prosthetic heart valve moving from the radially compressed configuration to the radially expanded configuration.
8. The assembly of claim 7 , wherein moving the wire of the delivery apparatus in a second axial direction relative to the catheter shaft causes the first expansion element of the prosthetic heart valve to move in the second axial direction relative to the second expansion element of the prosthetic heart valve, which results in the frame of the prosthetic heart valve moving from the radially expanded configuration to the radially compressed configuration.
9. The assembly of claim 7 , wherein the first expansion element of the prosthetic heart valve extends axially through the second expansion element of the prosthetic heart valve.
10. The assembly of claim 7 , wherein the ratcheting mechanism of the prosthetic heart valve comprises a male component and a female component, wherein the male component has a plurality of bumps, and wherein the female component has holes configured for receiving the bumps of the male component.
11. The assembly of claim 7 , wherein the catheter shaft of the delivery apparatus is configured to contact the second expansion element of the prosthetic heart valve to provide an opposing force in a second axial direction when the wire of the delivery apparatus and the first expansion element of the prosthetic heart valve are moved in the first axial direction relative to the catheter shaft of the delivery apparatus and the second expansion element of the prosthetic heart valve.
12. The assembly of claim 7 , wherein the delivery apparatus is configured for implanting the prosthetic heart valve in a native aortic valve using a transfemoral delivery approach.