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 a length from the inflow end to the outflow end, an annulus portion adjacent the inflow end, an aortic portion adjacent the outflow end and an intermediate portion between the annulus portion and the aortic portion, the stent including a plurality of struts circumscribing a plurality of open areas of the stent, the intermediate portion of the stent including enlarged open areas that are larger than the open areas in the annulus portion of the stent and the open areas in the aortic portion of the stent;
a plurality of valve leaflets supported by the stent; and
a cuff connected to the annulus portion of the stent,
wherein the cuff has a first wall overlapping in the longitudinal direction with the plurality of valve leaflets, a second wall radially outward of the first wall, and a space between the first wall and the second wall, the first wall having a first length in the longitudinal direction less than the length of the stent such that an outflow end of the first wall is positioned at a spaced distance from the outflow end of the stent and the second wall having a second length in the longitudinal direction less than the first length, and the enlarged open areas are spaced from one another in a circumferential direction of the stent so that each of the enlarged open areas can be aligned with a coronary artery ostium in the native valsalva sinus of a patient.
2. The prosthetic heart valve as claimed in claim 1 , wherein the stent is self-expanding.
3. The prosthetic heart valve as claimed in claim 1 , wherein the stent is balloon expandable.
4. The prosthetic heart valve as claimed in claim 1 , wherein the stent further includes a plurality of commissure features between the inflow end and the outflow end.
5. The prosthetic heart valve as claimed in claim 4 , wherein the commissure features are spaced from one another in the circumferential direction of the stent so that each of the commissure features can be aligned with respective commissures of the native valve annulus of the patient when the enlarged open areas are aligned with the coronary artery ostia in the native valve annulus of the patient.
6. The prosthetic heart valve as claimed in claim 5 , wherein each of the enlarged open areas has a first maximum dimension in the circumferential direction and the stent has a second maximum dimension in the circumferential direction between each adjacent pair of enlarged open areas, the second maximum dimension being less than the first maximum dimension.
7. The prosthetic heart valve as claimed in claim 1 , wherein the open areas in the annulus portion of the stent are diamond shaped.
8. The prosthetic heart valve as claimed in claim 1 , wherein the open areas in the aortic portion of the stent are diamond shaped.
9. 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.
10. The prosthetic heart valve as claimed in claim 1 , wherein the cuff overlaps in the longitudinal direction with the plurality of valve leaflets.