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 a collapsed condition and an expanded condition, the stent extending in a longitudinal direction between an inflow end and an outflow end and having an annulus portion adjacent the inflow end, an aortic portion adjacent the outflow end, a length from the inflow end to the outflow end, and a plurality of linking struts, each of the linking struts having a first end connected to the annulus portion and a second end connected directly to the aortic portion, the second ends being spaced apart from one another in an annular direction around the aortic portion;
a plurality of commissure members each having a connected end connected to the annulus portion and a free end, each of the commissure members having an associated pair of the linking struts disposed on opposite sides of the commissure member in the annular direction, the associated pair of linking struts including a first linking strut and a second linking strut, the first linking strut and the second linking strut being spaced apart from one another by a distance in the annular direction that is less than the distance in the annular direction between the first linking strut and a next adjacent linking strut not in the associated pair such that the second linking strut is not between the first linking strut and the next adjacent linking strut, the associated pairs of linking struts being spaced apart from one another in the annular direction;
a plurality of valve leaflets supported by the stent; and
a cuff connected to the annulus portion of the stent, the cuff having an inside wall overlapping in the longitudinal direction with the plurality of valve leaflets and an outside wall, the inside wall having a first length in the longitudinal direction less than the length of the stent such that an outflow end of the inner wall is positioned at a spaced distance from the outflow end of the stent and the outside wall having a second length in the longitudinal direction less than the first length,
wherein the commissure members are spaced from one another in the annular direction around the annulus portion so that each of the commissure members can be aligned with respective commissures of a native valve annulus of a patient.
2. The prosthetic heart valve as claimed in claim 1 , wherein the commissure members are cantilevered from the annulus portion of the stent.
3. The prosthetic heart valve as claimed in claim 1 , wherein the stent is self-expanding.
4. The prosthetic heart valve as claimed in claim 1 , wherein the stent is balloon expandable.
5. The prosthetic heart valve as claimed in claim 1 , wherein the annulus portion of the stent in the expanded condition has a first diameter and the aortic portion of the stent in the expanded condition has a second diameter larger than the first diameter.
6. The prosthetic heart valve as claimed in claim 1 , wherein the annulus portion includes 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, each of the downstream apex portions having a tip pointing toward the outflow end of the stent, and the first end of each of the linking struts is connected to the tip of a respective one of the downstream apex portions.
7. The prosthetic heart valve as claimed in claim 1 , wherein the first end of each of the linking struts is directly connected to a respective one of the commissure members.
8. The prosthetic heart valve as claimed in claim 1 , wherein the outside wall of the cuff forms a sealing ring.
9. A prosthetic heart valve, comprising:
a stent having a collapsed condition and an expanded condition, the stent extending in a longitudinal direction between an inflow end and an outflow end and having an annulus portion adjacent the inflow end;
a plurality of commissure members each having a connected end connected to the annulus portion and a free end, the commissure members being spaced from one another in an annular direction around the annulus portion so that each of the commissure members can be aligned with respective commissures of a native valve annulus of a patient, each of the commissure members having adjacent commissure members in the annular direction;
a plurality of valve leaflets supported by the stent; and
a cuff connected to the annulus portion of the stent, wherein the cuff has an inside wall overlapping in the longitudinal direction with the plurality of valve leaflets, an outside wall, and a space between the inside wall and the outside wall, the inside wall having a first length in the longitudinal direction less than a length of the stent such that an outflow end of the inside wall is positioned at a spaced distance from the outflow end of the stent and the outside wall having a second length in the longitudinal direction less than the first length,
wherein the annulus portion includes 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, other than the cells the stent being devoid of structure between each one of the commissure members and its adjacent commissure members 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.
10. The prosthetic heart valve as claimed in claim 9 , wherein the connected end of each of the commissure members is connected to the annulus portion between a respective pair of the downstream apex portions that are adjacent to one another in the annular direction.
11. The prosthetic heart valve as claimed in claim 9 , wherein the upstream apex portions of the cells include a barb.
12. The prosthetic heart valve as claimed in claim 9 , wherein the downstream apex portions of the cells include a barb.
13. The prosthetic heart valve as claimed in claim 9 , wherein the outside wall of the cuff forms a sealing ring.
14. A prosthetic heart valve, comprising:
a stent having a collapsed condition and an expanded condition, the stent extending in a longitudinal direction between an inflow end and an outflow end and having an annulus portion adjacent the inflow end;
a plurality of commissure members each having a connected end connected to the annulus portion and a free end;
a plurality of valve leaflets supported by the stent; and
a cuff connected to the annulus portion of the stent,
wherein the annulus portion includes an edge that is most remote from the outflow end of the stent, the edge of the annulus portion includes a plurality of upstream apex portions each having a tip pointing away from the outflow end of the stent and a recessed edge portion aligned in the longitudinal direction of the stent with at least one of the commissure members, and the recessed edge portion has at least one of the upstream apex portions whose tip is closer to the outflow end of the stent than the tips of other upstream apex portions of the edge of the annulus portion, and
wherein the cuff has an inside wall overlapping in the longitudinal direction with the plurality of valve leaflets and an outside wall, the inside wall has a first length in the longitudinal direction less than a length of the stent such that an outflow end of the inner wall is positioned at a spaced distance from the outflow end of the stent and the outside wall has a second length in the longitudinal direction less than the first length.
15. The prosthetic heart valve as claimed in claim 14 , wherein the stent includes an aortic portion adjacent the outflow end and a plurality of linking struts, each of the linking struts having a first end connected to the annulus portion and a second end connected to the aortic portion, the second ends being spaced apart from one another in an annular direction around the aortic portion.
16. The prosthetic heart valve as claimed in claim 15 , wherein the annulus portion includes a plurality of closed perimeter diamond-shaped cells, each cell having a respective one of the upstream apex portions directly connected to a downstream apex portion at connection points, each of the downstream apex portions having a tip pointing toward the outflow end of the stent, and the first end of each of the linking struts is connected to the tip of a respective one of the downstream apex portions.
17. The prosthetic heart valve as claimed in claim 15 , wherein the first end of each of the linking struts is directly connected to a respective one of the commissure members.